1275834053 NPI number — MCDANIEL'S CONSULTING & COUNSELING INC

Table of content: (NPI 1275834053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275834053 NPI number — MCDANIEL'S CONSULTING & COUNSELING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCDANIEL'S CONSULTING & COUNSELING INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1275834053
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16131
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAVANNAH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31416-2831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-306-7714
Provider Business Mailing Address Fax Number:
912-756-4583

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 TIBET AVE APT 107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31406-9029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-349-0030
Provider Business Practice Location Address Fax Number:
912-349-7708
Provider Enumeration Date:
11/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MCDANIEL
Authorized Official First Name:
ANNE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
912-349-0030

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LPC005493 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 431162523A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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