1598876211 NPI number — MISS ELIZABETH M HYMAN LICSW

Table of content: MISS ELIZABETH M HYMAN LICSW (NPI 1598876211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598876211 NPI number — MISS ELIZABETH M HYMAN LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HYMAN
Provider First Name:
ELIZABETH
Provider Middle Name:
M
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LICSW
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:
1598876211
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 PARKER AVE
Provider Second Line Business Mailing Address:
APT 7
Provider Business Mailing Address City Name:
NEWPORT
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02840-6940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-847-0352
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTERLY
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02891-1853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-841-8896
Provider Business Practice Location Address Fax Number:
401-848-4192
Provider Enumeration Date:
08/31/2006

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: 1041C0700X , with the licence number:  ISW00460 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 406578 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1021100 . This is a "NHP - GROUP NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 62-58145 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 311822 . This is a "MAGELLAN- GROUP NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 7439-1 . This is a "BLUE CROSS/ BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 351318 . This is a "TRI-CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: EH06879 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com