1619917358 NPI number — MRS. VICKI COPELAND STEED L.C.S.W.

Table of content: MRS. VICKI COPELAND STEED L.C.S.W. (NPI 1619917358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619917358 NPI number — MRS. VICKI COPELAND STEED L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEED
Provider First Name:
VICKI
Provider Middle Name:
COPELAND
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAME
Provider Other First Name:
VICKI
Provider Other Middle Name:
COPELAND
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.C.S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1619917358
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:
109 PINEYWOOD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THOMASVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27360-3434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-475-0852
Provider Business Mailing Address Fax Number:
336-475-0445

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 PINEYWOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THOMASVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27360-3434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-475-0852
Provider Business Practice Location Address Fax Number:
336-475-0445
Provider Enumeration Date:
06/08/2006

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: 1041C0700X , with the licence number:  C000583 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 79531 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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