1558356931 NPI number — MARIAN PUGH LCSWC

Table of content: MARIAN PUGH LCSWC (NPI 1558356931)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558356931 NPI number — MARIAN PUGH LCSWC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PUGH
Provider First Name:
MARIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSWC
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:
1558356931
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 SCHILLING RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
HUNT VALLEY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21031-1191
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-527-0280
Provider Business Mailing Address Fax Number:
410-771-9208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 SCHILLING RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HUNT VALLEY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21031-1191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-527-0280
Provider Business Practice Location Address Fax Number:
410-771-9208
Provider Enumeration Date:
09/13/2005

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: 101YM0800X , with the licence number:  7557 , 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: 7140244 PPO . This is a "AUSHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 927622 . This is a "FIRST HEALTH NETWORK PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 057367 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 126581 . This is a "APS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 28670005 . This is a "CAREFIRST" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 54327701 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 263981 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2702256 HMO . This is a "AUSHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 263981 . This is a "ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 299692 . This is a "MHN" identifier . This identifiers is of the category "OTHER".




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