1497273445 NPI number — MRS. LUCINDA MARIE BLANCH BA, QMHS

Table of content: MRS. LUCINDA MARIE BLANCH BA, QMHS (NPI 1497273445)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497273445 NPI number — MRS. LUCINDA MARIE BLANCH BA, QMHS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLANCH
Provider First Name:
LUCINDA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BA, QMHS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAPARSO
Provider Other First Name:
LUCINDA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497273445
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
955 WINDHAM CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOARDMAN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44512-5035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-726-2888
Provider Business Mailing Address Fax Number:
330-726-9031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
955 WINDHAM CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOARDMAN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44512-5035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-726-2888
Provider Business Practice Location Address Fax Number:
330-726-9031
Provider Enumeration Date:
08/30/2017

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: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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