1215079843 NPI number — MRS. EMILY ROSE PIRO LICSW

Table of content: (NPI 1023155983)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215079843 NPI number — MRS. EMILY ROSE PIRO LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIRO
Provider First Name:
EMILY
Provider Middle Name:
ROSE
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:
MILLER
Provider Other First Name:
EMILY
Provider Other Middle Name:
ROSE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215079843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
72B WOODBURY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03801-3204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-427-1177
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 LADD ST STE 404
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03801-4080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-427-1177
Provider Business Practice Location Address Fax Number:
603-427-6555
Provider Enumeration Date:
02/12/2007

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:  942 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 343961000 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: D2AN0L5QKC . This is a "WELLPOINT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30420939 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14Y001139NH01 . This is a "ANTHEM BLUE CROSS AND BLUE SHIELD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 159019 . This is a "VALUEOPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 343961000 . This is a "MAGELLAN PROVIDOR ID NUMB" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 046730 . This is a "BLUE CROSS OF MAINE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 2061746 . This is a "CIGNA BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7415375 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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