1588722169 NPI number — LAURIE JANE PIERCE LPC

Table of content: LAURIE JANE PIERCE LPC (NPI 1588722169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588722169 NPI number — LAURIE JANE PIERCE LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIERCE
Provider First Name:
LAURIE
Provider Middle Name:
JANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LACY
Provider Other First Name:
LAURIE
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588722169
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:
PO BOX 689
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CALERA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35040-0689
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-755-8800
Provider Business Mailing Address Fax Number:
205-755-8882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3156 PELHAM PKWY
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
PELHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35124-2022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-685-9535
Provider Business Practice Location Address Fax Number:
205-755-8882
Provider Enumeration Date:
12/05/2006

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: 101YP2500X , with the licence number:  1804 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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