1316953482 NPI number — MR. CHRISTOPHER HUNTERA ABBOTT LCSW-C

Table of content: MR. CHRISTOPHER HUNTERA ABBOTT LCSW-C (NPI 1316953482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316953482 NPI number — MR. CHRISTOPHER HUNTERA ABBOTT LCSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABBOTT
Provider First Name:
CHRISTOPHER
Provider Middle Name:
HUNTERA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW-C
Provider Gender Code:
M

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:
1316953482
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 E WILSON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAGERSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21740-7412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-527-1414
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13102 GRANT SHOOK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENCASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17225-8686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-527-1414
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2006

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: 1041C0700X , with the licence number:  06346 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PHCS 2235067 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 000395600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 121741 . This is a "JOHN HOPKINS HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 614440-01 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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