1376609701 NPI number — POSTVILLE COMMUNITY SCHOOLS

Table of content: MEGHAN GRACE GANUNG LCSW (NPI 1801467444)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376609701 NPI number — POSTVILLE COMMUNITY SCHOOLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POSTVILLE COMMUNITY SCHOOLS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1376609701
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 717
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POSTVILLE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52162-0717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-864-7651
Provider Business Mailing Address Fax Number:
563-864-7659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
312 WEST POST STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POSTVILLE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52162-0717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-864-7651
Provider Business Practice Location Address Fax Number:
563-864-7659
Provider Enumeration Date:
12/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LENSING
Authorized Official First Name:
CLARA
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
563-864-7651

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0425389 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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