1417423799 NPI number — KRISTEN L SALVI LCSW

Table of content: KRISTEN L SALVI LCSW (NPI 1417423799)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417423799 NPI number — KRISTEN L SALVI LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALVI
Provider First Name:
KRISTEN
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1417423799
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5730 EXECUTIVE DR STE 230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CATONSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21228-1762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-402-2379
Provider Business Mailing Address Fax Number:
410-469-3085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CEDAR CREST VILLAGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMPTON PLAINS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07444-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-831-3540
Provider Business Practice Location Address Fax Number:
973-831-3503
Provider Enumeration Date:
10/15/2018

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:  44SC06077900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: 44SL06418000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 44SL06418000 . This is a "LSW LICENSE #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".