1235353244 NPI number — ANN C MORAY CMSW, LMHP

Table of content: ANN C MORAY CMSW, LMHP (NPI 1235353244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235353244 NPI number — ANN C MORAY CMSW, LMHP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORAY
Provider First Name:
ANN
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CMSW, LMHP
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:
1235353244
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 641130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68164-7130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-572-2907
Provider Business Mailing Address Fax Number:
402-572-3544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1309 HARLAN DR
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68005-6604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-572-2907
Provider Business Practice Location Address Fax Number:
402-572-3544
Provider Enumeration Date:
04/12/2007

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: 1041C0700X , with the licence number:  648 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com