1073983433 NPI number — LILLIE CHRISTINE HAUER RSW, MSW

Table of content: LILLIE CHRISTINE HAUER RSW, MSW (NPI 1073983433)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073983433 NPI number — LILLIE CHRISTINE HAUER RSW, MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAUER
Provider First Name:
LILLIE
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RSW, MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAUER
Provider Other First Name:
LILLIE
Provider Other Middle Name:
CHRISTINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1073983433
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
860 EAST RIVER PLACE SUITE 100, JACKSON, MS 39202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39202-3013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
769-251-5550
Provider Business Mailing Address Fax Number:
769-251-5590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 ROUX 61
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
NATCHEZ
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-897-8100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/29/2015

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: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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