1437442969 NPI number — MS. MARCIA ANNE TUTHILL MA, LMFT

Table of content: MS. MARCIA ANNE TUTHILL MA, LMFT (NPI 1437442969)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437442969 NPI number — MS. MARCIA ANNE TUTHILL MA, LMFT

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
TUTHILL

Provider First Name:
MARCIA

Provider Middle Name:
ANNE

Provider Name Prefix Text:
MS.

Provider Name Suffix Text:

Provider Credential Text:
MA, LMFT

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:
HUFTALEN

Provider Other First Name:
MARCIA

Provider Other Middle Name:
ANNE

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:
MA,LMFT

Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437442969

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
04/14/2016

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
74 VANCOUVER AVE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:
WARWICK

Provider Business Mailing Address State Name:
RI

Provider Business Mailing Address Postal Code:
02886-2841

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
401-440-3829

Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 BALD HILL RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:
WARWICK

Provider Business Practice Location Address State Name:
RI

Provider Business Practice Location Address Postal Code:
02886-1617

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
401-352-0007

Provider Business Practice Location Address Fax Number:
401-352-0023

Provider Enumeration Date:
05/17/2011

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: 106H00000X , with the licence number: 1527 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .