1184995706 NPI number — KARA M MAGILL LCSW

Table of content: KARA M MAGILL LCSW (NPI 1184995706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184995706 NPI number — KARA M MAGILL LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAGILL
Provider First Name:
KARA
Provider Middle Name:
M
Provider Name Prefix Text:
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:
MAGILL
Provider Other First Name:
KARA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1184995706
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2011 COMMERCE DR N
Provider Second Line Business Mailing Address:
SUITE D106
Provider Business Mailing Address City Name:
PEACHTREE CITY
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30269-3538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-953-5279
Provider Business Mailing Address Fax Number:
678-894-8472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2011 COMMERCE DR N
Provider Second Line Business Practice Location Address:
SUITE D106
Provider Business Practice Location Address City Name:
PEACHTREE CITY
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30269-3538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-953-5279
Provider Business Practice Location Address Fax Number:
678-894-8472
Provider Enumeration Date:
01/13/2012

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: 101YM0800X , with the licence number:  CSW004551 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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