1497863708 NPI number — MR. LAWRENCE R STOUTER LCPC

Table of content: MR. LAWRENCE R STOUTER LCPC (NPI 1497863708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497863708 NPI number — MR. LAWRENCE R STOUTER LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOUTER
Provider First Name:
LAWRENCE
Provider Middle Name:
R
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STOUTER
Provider Other First Name:
LARRY
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1497863708
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 E WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAGERSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21740-5721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-745-6687
Provider Business Mailing Address Fax Number:
301-739-0041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
228 E WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21740-5721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-745-6687
Provider Business Practice Location Address Fax Number:
301-739-0041
Provider Enumeration Date:
08/27/2006

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:  LC0301 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2235173 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 178977 . This is a "COMPSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: T5150001 . This is a "CAREFIRST BCBS - NCA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5482516 . This is a "AETNA (CCC)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1992391 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 452936 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2052870 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0X38CA . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com