1447452172 NPI number — DELAYNE MAY LCPC

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 1447452172 NPI number — DELAYNE MAY LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAY
Provider First Name:
DELAYNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LOCKETT
Provider Other First Name:
DELAYNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447452172
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 677
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OTTAWA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66067-0677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-242-3780
Provider Business Mailing Address Fax Number:
785-242-6397

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2537 EISENHOWER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OTTAWA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66067-9482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-242-3780
Provider Business Practice Location Address Fax Number:
785-242-6397
Provider Enumeration Date:
06/04/2007

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: 101YM0800X , with the licence number:  LCPC 263 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200438470C , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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