1326128000 NPI number — THERESA M HORSTMAN LCSW

Table of content: THERESA M HORSTMAN LCSW (NPI 1326128000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326128000 NPI number — THERESA M HORSTMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORSTMAN
Provider First Name:
THERESA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1326128000
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 SNYDER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERMITAGE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16148-3432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-981-2773
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 SNYDER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERMITAGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16148-3432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-981-2773
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2006

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: 1041C0700X , with the licence number:  CW014101 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 336643 . This is a "VALUE OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 552127 . This is a "BCBS SEC65 SPECIAL SE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0011099910001 . This is a "DPW" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0489834 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 202179 . This is a "UPMC POS HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25163861200 . This is a "COGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0489834 . This is a "AETNA HMO MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 845744 . This is a "KHPW HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0789384 . This is a "DPW" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 336643 . This is a "VALUE OPTIONS VA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000115000 . This is a "ONE NATION BENEFIT ADMIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 251638612 . This is a "MEDICAL MUT PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 845744 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: E52896 . This is a "HEALTH ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 336643 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 215580000 . This is a "MAGELLAN BEHAVIORAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 845744 . This is a "BCBS PPO POS HMO TRAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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