1740298199 NPI number — MARGARET ELIZABETH KITCHENS LISW-C, CEAP

Table of content: MARGARET ELIZABETH KITCHENS LISW-C, CEAP (NPI 1740298199)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740298199 NPI number — MARGARET ELIZABETH KITCHENS LISW-C, CEAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KITCHENS
Provider First Name:
MARGARET
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LISW-C, CEAP
Provider Gender Code:
F

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:
1740298199
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 538622
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30353-8622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-742-9243
Provider Business Mailing Address Fax Number:
888-746-1787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2101 DUTCH FORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAPIN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29036-7576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-742-9243
Provider Business Practice Location Address Fax Number:
888-746-1787
Provider Enumeration Date:
08/03/2006

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:  05504 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 11791 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 11791 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 547530-01 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: PHCS2236109 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 000395600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 121738 . This is a "JOHN HOPKINS HEALTCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com