1659026748 NPI number — MRS. APRIL CHRISTINA LUNCEFORD LMSW, CSOTS

Table of content: MRS. APRIL CHRISTINA LUNCEFORD LMSW, CSOTS (NPI 1659026748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659026748 NPI number — MRS. APRIL CHRISTINA LUNCEFORD LMSW, CSOTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUNCEFORD
Provider First Name:
APRIL
Provider Middle Name:
CHRISTINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW, CSOTS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUNCEFORD
Provider Other First Name:
CHRISTY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW, CSOTS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1659026748
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
641 19TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEWISTON
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83501-3893
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-305-7012
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
641 19TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83501-3893
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-305-7012
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/16/2022

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: 104100000X , with the licence number:  LMSW41679 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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