1457310823 NPI number — DIAN S DOWELL LPC

Table of content: DIAN S DOWELL LPC (NPI 1457310823)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457310823 NPI number — DIAN S DOWELL LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOWELL
Provider First Name:
DIAN
Provider Middle Name:
S
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:
1457310823
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6655 S YALE AVE
Provider Second Line Business Mailing Address:
LAUREATE PSYCHIATRIC CLINC AND HOSPITAL
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74136-3326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-481-4000
Provider Business Mailing Address Fax Number:
918-491-5740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6655 S YALE AVE
Provider Second Line Business Practice Location Address:
LAUREATE PSYCHIATRIC CLINC AND HOSPITAL
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74136-3326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-481-4000
Provider Business Practice Location Address Fax Number:
918-491-5740
Provider Enumeration Date:
03/22/2006

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:  1226 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2032900 . This is a "CIGNA BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".