1326089343 NPI number — JANET E WILSON LCSWC

Table of content: JANET E WILSON LCSWC (NPI 1326089343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326089343 NPI number — JANET E WILSON LCSWC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILSON
Provider First Name:
JANET
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSWC
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:
1326089343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 SISTER PIERRE DRIVE
Provider Second Line Business Mailing Address:
STE 403
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-823-6408
Provider Business Mailing Address Fax Number:
443-279-0537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 SISTER PIERRE DRIVE
Provider Second Line Business Practice Location Address:
STE 403
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-823-6408
Provider Business Practice Location Address Fax Number:
443-279-0537
Provider Enumeration Date:
06/09/2006

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:  05118 , 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: 790298000 . This is a "MAGE GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: PVPB117105 . This is a "APS GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0020 . This is a "BSDC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 226291 . This is a "KAIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: K452 . This is a "BSDC GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 226756000 . This is a "MAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 002125 . This is a "VAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 226291 . This is a "KAIS GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 705BPS . This is a "BSMD GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9397886 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 150N . This is a "MBMD GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 391117 . This is a "MAMS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 52092404 . This is a "BSMD" identifier . This identifiers is of the category "OTHER".
  • Identifier: PVPB117105 . This is a "APS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 150N130G . This is a "MBMD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 252450 . This is a "COMP GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 253561 . This is a "COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 331833 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 593795443 . This is a "MAMS GROUP #" identifier . This identifiers is of the category "OTHER".




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