1982837134 NPI number — INT'L SOCIAL WORK & COUNSELING AGENCY, LLC

Table of content: (NPI 1982837134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982837134 NPI number — INT'L SOCIAL WORK & COUNSELING AGENCY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INT'L SOCIAL WORK & COUNSELING AGENCY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1982837134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41034 MARKS DR STE 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NOVI
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48375-4932
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-767-5864
Provider Business Mailing Address Fax Number:
248-348-7188

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41034 MARKS DR STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOVI
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48375-4932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-767-5864
Provider Business Practice Location Address Fax Number:
248-348-7188
Provider Enumeration Date:
09/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SHAMOON
Authorized Official First Name:
ULFAT
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
248-767-2413

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  B7606N , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com