1386629509 NPI number — MS. AUGUSTA T ROSENTHAL MSW

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386629509 NPI number — MS. AUGUSTA T ROSENTHAL MSW

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ROSENTHAL

Provider First Name:

AUGUSTA

Provider Middle Name:

T

Provider Name Prefix Text:

MS.

Provider Name Suffix Text:

Provider Credential Text:

MSW

Provider Gender Code:

F

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:

1386629509

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/08/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

19 BISHOP RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ROCHESTER

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

02770-1801

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

508-763-9577

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

19 COUNTY RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

MATTAPOISETT

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

02739-1584

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

508-758-3754

Provider Business Practice Location Address Fax Number:

508-758-3755

Provider Enumeration Date:

12/09/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 1041C0700X , with the licence number:  102386 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000000026565 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
• Identifier: 102386 . This is a "BOARD OF SOC WK REGIS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 1851349 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 1891570 . This is a "MASS BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 209009 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: 6251540 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 025376 . This is a "VMC BEHAVIORAL HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: P03979 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 0007362127 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 9052725 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier . This identifiers is of the category "OTHER".
• Identifier: 000000026565 . This is a "BOSTON MEDICAL CENTER" identifier . This identifiers is of the category "OTHER".
• Identifier: 102386 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
• Identifier: 1041382 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 114148 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".