1326389966 NPI number — MRS. FAITH MARIE SAWYER CASPER LCPC

Table of content: MRS. FAITH MARIE SAWYER CASPER LCPC (NPI 1326389966)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326389966 NPI number — MRS. FAITH MARIE SAWYER CASPER LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAWYER CASPER
Provider First Name:
FAITH
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAWYER
Provider Other First Name:
FAITH
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326389966
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3023 E COPPER POINT DR
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
MERIDIAN
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83642-9290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-514-0518
Provider Business Mailing Address Fax Number:
208-493-8759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3023 E COPPER POINT DR
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
MERIDIAN
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83642-9290
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-514-0518
Provider Business Practice Location Address Fax Number:
208-493-8759
Provider Enumeration Date:
03/06/2013

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: 101YM0800X , with the licence number:  LCPC-6470 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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