1306950878 NPI number — SUZANNE MUHLMANN LICSW

Table of content: SUZANNE MUHLMANN LICSW (NPI 1306950878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306950878 NPI number — SUZANNE MUHLMANN LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUHLMANN
Provider First Name:
SUZANNE
Provider Middle Name:
Provider Name Prefix Text:
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:
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:
1306950878
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:
9 COLLEGE ST
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
SOUTH HADLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01075-1421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-534-7400
Provider Business Mailing Address Fax Number:
413-534-7483

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 SOUTHAMPTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01085-1370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-572-9900
Provider Business Practice Location Address Fax Number:
413-572-9901
Provider Enumeration Date:
08/19/2006

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: 104100000X , with the licence number:  110720 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P06108 . This is a "BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com