1033597133 NPI number — JUDY C LEYERZAPF LMHCA

Table of content: JUDY C LEYERZAPF LMHCA (NPI 1033597133)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033597133 NPI number — JUDY C LEYERZAPF LMHCA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEYERZAPF
Provider First Name:
JUDY
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHCA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEYERZAPF
Provider Other First Name:
JUDITH
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHCA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1033597133
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11802 E MANSFIELD AVE STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE VALLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99206-4788
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-473-9157
Provider Business Mailing Address Fax Number:
509-343-1622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11802 E MANSFIELD AVE STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-4788
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-473-9157
Provider Business Practice Location Address Fax Number:
509-343-1622
Provider Enumeration Date:
05/11/2015

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: 101YM0800X , with the licence number:  MC60405953 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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