1356360754 NPI number — MRS. RACHEL ILENE KANFER L.M.S.W.

Table of content: MRS. RACHEL ILENE KANFER L.M.S.W. (NPI 1356360754)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356360754 NPI number — MRS. RACHEL ILENE KANFER L.M.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KANFER
Provider First Name:
RACHEL
Provider Middle Name:
ILENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.M.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZAGER
Provider Other First Name:
RACHEL
Provider Other Middle Name:
ILENE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.M.S.W.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1356360754
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
725 S ADAMS RD
Provider Second Line Business Mailing Address:
235
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48009-6902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-593-9276
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6960 ORCHARD LAKE RD
Provider Second Line Business Practice Location Address:
100
Provider Business Practice Location Address City Name:
WEST BLOOMFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48322-4515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-626-1500
Provider Business Practice Location Address Fax Number:
248-626-1551
Provider Enumeration Date:
07/18/2006

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:  077541 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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