1689629586 NPI number — MS. MARGARET KATRINA HARDIN LCPC CCMHC

Table of content: MS. MARGARET KATRINA HARDIN LCPC CCMHC (NPI 1689629586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689629586 NPI number — MS. MARGARET KATRINA HARDIN LCPC CCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDIN
Provider First Name:
MARGARET
Provider Middle Name:
KATRINA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCPC CCMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLAGLER
Provider Other First Name:
MARGARET
Provider Other Middle Name:
HARDIN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCPC CCMHC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689629586
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:
5407 N CHARLES ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21210-2024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-433-8861
Provider Business Mailing Address Fax Number:
410-433-1249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5407 N CHARLES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21210-2024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-433-8861
Provider Business Practice Location Address Fax Number:
410-433-1249
Provider Enumeration Date:
05/23/2006

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: 101Y00000X , with the licence number:  LL0025 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 102205 . This is a "JOHN HOPKINS HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 69773801 . This is a "CAREFIRST BC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 177319 . This is a "MANAGED HEALTH NETWORK TR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 237674 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 199525 . This is a "COM PSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0004 . This is a "FED BC" identifier . This identifiers is of the category "OTHER".




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