1427046580 NPI number — CAROLYN MARGARET SMITH LPC

Table of content: MEGAN BURKETT FNP (NPI 1629518725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427046580 NPI number — CAROLYN MARGARET SMITH LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
CAROLYN
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
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:
1427046580
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10475 PERRY HWY STE 300
Provider Second Line Business Mailing Address:
TOWN CENTRE
Provider Business Mailing Address City Name:
WEXFORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15090-9213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-759-7500
Provider Business Mailing Address Fax Number:
724-759-7600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9983 PERRY HWY
Provider Second Line Business Practice Location Address:
MERCY BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
WEXFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15090-9297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-933-8200
Provider Business Practice Location Address Fax Number:
724-935-8716
Provider Enumeration Date:
10/12/2005

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: 101YP2500X , with the licence number:  PC001727 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001524307 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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