1346798246 NPI number — VIRGINIA DOWSON MA, CCS, ICADC, LBSW

Table of content: VIRGINIA DOWSON MA, CCS, ICADC, LBSW (NPI 1346798246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346798246 NPI number — VIRGINIA DOWSON MA, CCS, ICADC, LBSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOWSON
Provider First Name:
VIRGINIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, CCS, ICADC, LBSW
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:
1346798246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32969 HAMILTON CT
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48334-3351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-324-9744
Provider Business Mailing Address Fax Number:
248-324-9755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32969 HAMILTON CT
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
FARMINGTON HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48334-3351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-324-9744
Provider Business Practice Location Address Fax Number:
248-324-9755
Provider Enumeration Date:
09/20/2016

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: 101YA0400X , with the licence number:  SA0631233 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: 6802068534 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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