1205819182 NPI number — MRS. LYNNE M DUVAL LICSW

Table of content: MRS. LYNNE M DUVAL LICSW (NPI 1205819182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205819182 NPI number — MRS. LYNNE M DUVAL LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUVAL
Provider First Name:
LYNNE
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
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:
1205819182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
468 ROUTE 13 S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILFORD
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03055-3488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-672-1881
Provider Business Mailing Address Fax Number:
603-672-1444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
468 ROUTE 13 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILFORD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03055-3488
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-672-1881
Provider Business Practice Location Address Fax Number:
603-589-1285
Provider Enumeration Date:
11/23/2005

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:  1207 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 378707 . This is a "MVP HEALTH CARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 201985623 . This is a "GREAT-WEST HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 20-1985623 . This is a "TRICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 201985623 . This is a "GUARDIAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 3079631 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14Y001736NH02 . This is a "ANTHEM BCBSNH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 201985623 . This is a "MARTINS POINT" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 523414 . This is a "VALUEOPTIONS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 2196980 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 20-1985623-01 . This is a "PACIFICARE BEHAVIORAL HEA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 201985623 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 351210 . This is a "MHN GROUP PROVIDER #" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 737424000 . This is a "MAGELLAN HEALTH SERVICES" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 201985623 . This is a "AETNA BEHAVIORAL HEALTH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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