1265786628 NPI number — APRIL RENEE HARVIN LCSW

Table of content: APRIL RENEE HARVIN LCSW (NPI 1265786628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265786628 NPI number — APRIL RENEE HARVIN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARVIN
Provider First Name:
APRIL
Provider Middle Name:
RENEE
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:
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:
1265786628
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1028 RHINELANDER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10461-1308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-352-9034
Provider Business Mailing Address Fax Number:
212-696-1602

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37 W 26TH ST
Provider Second Line Business Practice Location Address:
6TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010-1006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-696-1550
Provider Business Practice Location Address Fax Number:
212-696-1602
Provider Enumeration Date:
11/06/2012

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: 1041C0700X , with the licence number:  072343 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0250677 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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