1497106181 NPI number — MEGHAN HOLDEN LPC-CR

Table of content: MEGHAN HOLDEN LPC-CR (NPI 1497106181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497106181 NPI number — MEGHAN HOLDEN LPC-CR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLDEN
Provider First Name:
MEGHAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC-CR
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:
1497106181
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202 E BAGLEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEREA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44017-2058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-260-8300
Provider Business Mailing Address Fax Number:
440-260-8305

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3500 CARNEGIE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44115-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-260-8900
Provider Business Practice Location Address Fax Number:
440-260-8576
Provider Enumeration Date:
06/24/2016

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:  C.1400331-CR , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: M.1500014 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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