1578504411 NPI number — RHONDA JANICE LOFTIS LPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578504411 NPI number — RHONDA JANICE LOFTIS LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOFTIS
Provider First Name:
RHONDA
Provider Middle Name:
JANICE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HONEYCUTT
Provider Other First Name:
RHONDA
Provider Other Middle Name:
JANICE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578504411
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:
800 FLEMING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSONVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28791-3528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-697-4160
Provider Business Mailing Address Fax Number:
828-693-9560

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
513 N JUSTICE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28739-4217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-697-4187
Provider Business Practice Location Address Fax Number:
828-697-4488
Provider Enumeration Date:
06/10/2006

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:  4923 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6102689 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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