1720113046 NPI number — MR. BOB L HALPIN LCSW LMFT

Table of content: MR. BOB L HALPIN LCSW LMFT (NPI 1720113046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720113046 NPI number — MR. BOB L HALPIN LCSW LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALPIN
Provider First Name:
BOB
Provider Middle Name:
L
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW LMFT
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:
1720113046
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:
151 E 5600 SO SUITE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURRAY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-266-7858
Provider Business Mailing Address Fax Number:
801-266-7858

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
INDEPENDENCE SQUARE 151 E 5600 SO SUITE 110
Provider Second Line Business Practice Location Address:
ROBERT L. HALPIN, LCSW
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-266-7858
Provider Business Practice Location Address Fax Number:
801-266-7858
Provider Enumeration Date:
02/23/2007

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: 104100000X , with the licence number:  1070573501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 1070573902 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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