1396937009 NPI number — JOHNSON COUNSELING AND CONSULTING

Table of content: DR. PRAFULLCHANDRA DOLATRAI VORA M.D. (NPI 1447256342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396937009 NPI number — JOHNSON COUNSELING AND CONSULTING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHNSON COUNSELING AND CONSULTING
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:
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:
1396937009
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 KING ST
Provider Second Line Business Mailing Address:
SUITE 227
Provider Business Mailing Address City Name:
LA CROSSE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54601-9204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-796-2710
Provider Business Mailing Address Fax Number:
608-796-2712

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 KING ST
Provider Second Line Business Practice Location Address:
SUITE 227
Provider Business Practice Location Address City Name:
LA CROSSE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54601-9204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-796-2710
Provider Business Practice Location Address Fax Number:
608-796-2712
Provider Enumeration Date:
08/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
608-796-2710

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  2267 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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