1184780124 NPI number — MS. L PARKER JONES LICSW

Table of content: MS. L PARKER JONES LICSW (NPI 1184780124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184780124 NPI number — MS. L PARKER JONES LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
L
Provider Middle Name:
PARKER
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LICSW
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:
1184780124
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 NEWBURYPORT TPKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWBURY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01951-1113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-499-2830
Provider Business Mailing Address Fax Number:
978-465-7474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 NEWBURYPORT TURNPIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBURY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01951
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-499-2830
Provider Business Practice Location Address Fax Number:
978-465-7474
Provider Enumeration Date:
12/27/2006

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:  1020654 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 282820000 . This is a "MAGELLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P06061 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5668222 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 102065 . This is a "TNFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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