1649756222 NPI number — LAUREN PASQUA, PSYD

Table of content: (NPI 1649756222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649756222 NPI number — LAUREN PASQUA, PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAUREN PASQUA, PSYD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CONNECTIONS CHILD & FAMILY CENTER
Provider Other Organization Name Type Code:
3
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:
1649756222
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16918 WINDYPINE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77379-6429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-964-2904
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1544 SAWDUST RD STE 290
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77380-2903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-210-6677
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JESSUP
Authorized Official First Name:
LAUREN
Authorized Official Middle Name:
PASQUA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
404-964-2904

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC2200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133VN1201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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