1114162021 NPI number — MRS. MARCELA FERNANDEZ ATAYDE LCSW

Table of content: MRS. MARCELA FERNANDEZ ATAYDE LCSW (NPI 1114162021)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114162021 NPI number — MRS. MARCELA FERNANDEZ ATAYDE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATAYDE
Provider First Name:
MARCELA
Provider Middle Name:
FERNANDEZ
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FERNANDEZ-VANROO
Provider Other First Name:
MARCELA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1114162021
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12591 FIRENZE HTS
Provider Second Line Business Mailing Address:
APT 2111
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-526-5201
Provider Business Mailing Address Fax Number:
562-981-7569

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12591 FIRENZE HTS
Provider Second Line Business Practice Location Address:
APT 2111
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-526-5201
Provider Business Practice Location Address Fax Number:
562-981-7569
Provider Enumeration Date:
12/05/2008

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:  ASW 22674 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CSW.09924948 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com