1477792638 NPI number — DR. KATHLEEN ANN MEHL CHADWICK PH.D., L.P.C.

Table of content: DR. KATHLEEN ANN MEHL CHADWICK PH.D., L.P.C. (NPI 1477792638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477792638 NPI number — DR. KATHLEEN ANN MEHL CHADWICK PH.D., L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEHL CHADWICK
Provider First Name:
KATHLEEN
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEHL
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.P.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477792638
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 N CLAYVIEW DR
Provider Second Line Business Mailing Address:
WESTOWNE 2, CHADWICK PROFESSIONAL OFFICES
Provider Business Mailing Address City Name:
LIBERTY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64068-1116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-797-9437
Provider Business Mailing Address Fax Number:
816-502-0477

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 N CLAYVIEW DR
Provider Second Line Business Practice Location Address:
WESTOWNE 2, CHADWICK PROFESSIONAL OFFICES
Provider Business Practice Location Address City Name:
LIBERTY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64068-1116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-797-9437
Provider Business Practice Location Address Fax Number:
816-502-0477
Provider Enumeration Date:
02/11/2009

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:  000265 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com