1336458926 NPI number — DERRY CATHERINE O'KANE LCMHC

Table of content: DERRY CATHERINE O'KANE LCMHC (NPI 1336458926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336458926 NPI number — DERRY CATHERINE O'KANE LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'KANE
Provider First Name:
DERRY
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCMHC
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:
1336458926
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 RIVERBEND DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHERVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-808-2473
Provider Business Mailing Address Fax Number:
360-671-3574

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 RIVERBEND DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHERVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-808-2473
Provider Business Practice Location Address Fax Number:
360-671-3574
Provider Enumeration Date:
09/29/2010

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 10874 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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