1255671558 NPI number — SALEM STATE UNIVERSITY

Table of content: (NPI 1255671558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255671558 NPI number — SALEM STATE UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SALEM STATE UNIVERSITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COUNSELING AND HEALTH SERVICES
Provider Other Organization Name Type Code:
5
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:
1255671558
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
352 LAFAYETTE ST
Provider Second Line Business Mailing Address:
COUNSELING AND HEALTH SERVICES
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01970-5348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-542-6410
Provider Business Mailing Address Fax Number:
978-542-7121

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
352 LAFAYETTE ST
Provider Second Line Business Practice Location Address:
COUNSELING AND HEALTH SERVICES
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01970-5348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-542-6410
Provider Business Practice Location Address Fax Number:
978-542-7121
Provider Enumeration Date:
02/22/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DALY
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
ASSOCIATE DIRECTOR
Authorized Official Telephone Number:
978-542-6410

Provider Taxonomy Codes

  • Taxonomy code: 261QS1000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 80840-1174679898 . This is a "NPI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 80840-1881645380 . This is a "NPI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 80840-1124068663 . This is a "NPI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 80840-1801835392 . This is a "NPI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".