1447240288 NPI number — MR. ADAM M LESSER MSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447240288 NPI number — MR. ADAM M LESSER MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LESSER
Provider First Name:
ADAM
Provider Middle Name:
M
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
M

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:
1447240288
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5160 JOEL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30360-1412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-285-0149
Provider Business Mailing Address Fax Number:
815-572-0120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5160 JOEL COURT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30360-1412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-285-0149
Provider Business Practice Location Address Fax Number:
815-572-0120
Provider Enumeration Date:
10/24/2005

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: 1041C0700X , with the licence number:  CSW004012 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7799218 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 010547 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 361138 . This is a "MHN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 263860000 . This is a "CMSP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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