1205166857 NPI number — MRS. KATHYRN H SMITH LCMHC

Table of content: MRS. KATHYRN H SMITH LCMHC (NPI 1205166857)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205166857 NPI number — MRS. KATHYRN H SMITH LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
KATHYRN
Provider Middle Name:
H
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205166857
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 S BABOOSIC LAKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRIMACK
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03054-2926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-424-6476
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 TECHNOLOGY WAY
Provider Second Line Business Practice Location Address:
SUITE 3W7
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03060-3245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-886-5565
Provider Business Practice Location Address Fax Number:
603-886-8642
Provider Enumeration Date:
01/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  789 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 789 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com