1043236813 NPI number — ELIZABETH F HALTON LCSW-R

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043236813 NPI number — ELIZABETH F HALTON LCSW-R

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALTON
Provider First Name:
ELIZABETH
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW-R
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:
1043236813
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3043 STATE ROUTE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUDSON FALLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12839-9632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-747-2284
Provider Business Mailing Address Fax Number:
518-747-2253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3043 STATE ROUTE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUDSON FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12839-9632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-747-2284
Provider Business Practice Location Address Fax Number:
518-747-2253
Provider Enumeration Date:
07/14/2006

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:  00032265 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00400166001 . This is a "MEDICARE SENIOR BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426031843 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00400166001 . This is a "EMPIRE BC/BS BLUE CARD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00400166001 . This is a "EMPIRE BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00032265 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 53088 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00400166001 . This is a "HEALTHNOW INTEGRATED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11586598 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 26749 . This is a "BLUESHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: N91681 . This is a "BLUECROSS BLUESHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00400166001 . This is a "BLUE SHIELD OF NORTHEASTERN NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00817783 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".




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