1124085543 NPI number — MRS. KAROLA THURMAN LCSW

Table of content: MRS. KAROLA THURMAN LCSW (NPI 1124085543)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124085543 NPI number — MRS. KAROLA THURMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THURMAN
Provider First Name:
KAROLA
Provider Middle Name:
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:
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:
1124085543
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
385 GARRISONVILLE RD
Provider Second Line Business Mailing Address:
113
Provider Business Mailing Address City Name:
STAFFORD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22554-1545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-657-1228
Provider Business Mailing Address Fax Number:
540-657-1999

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
385 GARRISONVILLE RD
Provider Second Line Business Practice Location Address:
113
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22554-1545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-657-1228
Provider Business Practice Location Address Fax Number:
540-657-1999
Provider Enumeration Date:
04/28/2006

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:  0904005606 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 360140 . This is a "TRICARE PRIME" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 14553 . This is a "UBH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 350648 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 546140 . This is a "VALUE OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7143597 . This is a "AETNA MC, EPO & PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541183037 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 727318000 . This is a "MAGELLAN" identifier , issued by the state of ( VI ) . This identifiers is of the category "OTHER".
  • Identifier: 2138456 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 360140 . This is a "MHN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1124085543 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2475280 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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