1265401657 NPI number — MRS. KAREN RENEE HOBBS LPC

Table of content: MRS. KAREN RENEE HOBBS LPC (NPI 1265401657)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265401657 NPI number — MRS. KAREN RENEE HOBBS LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOBBS
Provider First Name:
KAREN
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
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:
1265401657
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4408 ECHO CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBRIDGE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22193-2713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-772-2023
Provider Business Mailing Address Fax Number:
706-670-0172

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4000 GENESEE PL
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
WOODBRIDGE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22192-8302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-583-7504
Provider Business Practice Location Address Fax Number:
703-583-7507
Provider Enumeration Date:
03/16/2006

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: 101YM0800X , with the licence number:  0701003114 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PVPB212014 . This is a "KAISER PIN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 30442 . This is a "NPC ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: N23131871 . This is a "UBH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 11233583 . This is a "CAQH NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5412978 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: F881 . This is a "HEALTHKEEPERS/CAREFIRST #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 171858 . This is a "ANTHEM PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7674370 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 462231 . This is a "VALUE OPTIONS PIN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 448830 . This is a "MDIPA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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