1104240407 NPI number — MR. CHRISTOPHER MORANDI LPCC-S

Table of content: MR. CHRISTOPHER MORANDI LPCC-S (NPI 1104240407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104240407 NPI number — MR. CHRISTOPHER MORANDI LPCC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORANDI
Provider First Name:
CHRISTOPHER
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LPCC-S
Provider Gender Code:
M

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:
1104240407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 GREENUP ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COVINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41011-2524
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-349-0700
Provider Business Mailing Address Fax Number:
859-208-2600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
526 PHILADELPHIA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41011-1239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-349-0700
Provider Business Practice Location Address Fax Number:
859-208-2600
Provider Enumeration Date:
02/07/2014

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: 101YP2500X , with the licence number:  E.1600029 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: 1649 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 471002619 . This is a "TAX ID" identifier . This identifiers is of the category "OTHER".




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