1174759229 NPI number — MS. JACQUELINE ANN SPRIGGLE LCSW

Table of content: MS. JACQUELINE ANN SPRIGGLE LCSW (NPI 1174759229)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174759229 NPI number — MS. JACQUELINE ANN SPRIGGLE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPRIGGLE
Provider First Name:
JACQUELINE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
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:
ALBIN
Provider Other First Name:
JACQUELINE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174759229
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
274 OAK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIFFLINTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17059-8535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-320-2165
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 N CARLISLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BLOOMFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17068-9660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-320-2165
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2009

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: 104100000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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