1063463990 NPI number — MRS. MARGARET CLARE FOLEY M.S.W., L.I.S.W.

Table of content: MRS. MARGARET CLARE FOLEY M.S.W., L.I.S.W. (NPI 1063463990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063463990 NPI number — MRS. MARGARET CLARE FOLEY M.S.W., L.I.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOLEY
Provider First Name:
MARGARET
Provider Middle Name:
CLARE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., L.I.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOLEY
Provider Other First Name:
MARGIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.W., L.I.S.W.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1063463990
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:
PO BOX 248
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLBROOK
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45305-0248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-848-9006
Provider Business Mailing Address Fax Number:
937-848-9006

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
42 W FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLBROOK
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45305-1903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-848-9006
Provider Business Practice Location Address Fax Number:
937-848-9006
Provider Enumeration Date:
05/15/2006

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:  I0006007 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000489318 . This is a "ANTHEM BC BS OF OHIO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 344988 . This is a "TRICARE PALMETTO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 5609510000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7805583 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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