1487742615 NPI number — LAWRENCE UMAN M.A.

Table of content: LAWRENCE UMAN M.A. (NPI 1487742615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487742615 NPI number — LAWRENCE UMAN M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UMAN
Provider First Name:
LAWRENCE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
M

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:
1487742615
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11870 SUNRISE VALLEY DR
Provider Second Line Business Mailing Address:
#200
Provider Business Mailing Address City Name:
RESTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20191-3304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-391-7380
Provider Business Mailing Address Fax Number:
703-391-7381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11870 SUNRISE VALLEY DR
Provider Second Line Business Practice Location Address:
#200
Provider Business Practice Location Address City Name:
RESTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20191-3304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-391-7380
Provider Business Practice Location Address Fax Number:
703-391-7381
Provider Enumeration Date:
10/11/2006

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: 101YM0800X , with the licence number:  LPC 0701002320 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT 0717000267 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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