1669405940 NPI number — CLAIRE ZANG, PSYCHOTHERAPIST, LCSW, LLC

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 1669405940 NPI number — CLAIRE ZANG, PSYCHOTHERAPIST, LCSW, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLAIRE ZANG, PSYCHOTHERAPIST, LCSW, LLC
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:
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:
1669405940
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 GOLDEN HILL STREET
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
BRIDGEPORT
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-243-0929
Provider Business Mailing Address Fax Number:
203-331-8288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 GOLDEN HILL STREET
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-243-0929
Provider Business Practice Location Address Fax Number:
203-331-8288
Provider Enumeration Date:
07/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZANG
Authorized Official First Name:
CLAIRE
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHOTHERAPIST
Authorized Official Telephone Number:
203-243-0929

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  004352 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 048768102 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 140004352CT03 . This is a "ANTHEM BLUE CROSS BLUE SH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 297496 . This is a "MHN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: C03276 . This is a "MEDICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 7354466 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 004236312 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 453920 . This is a "VALUE OPTIONS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P2949830 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11546151 . This is a "CAQH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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