1669542858 NPI number — MS. PAULETTE M. CHARTIER APRN, BC

Table of content: MICHAEL DEGRUTT LMFT (NPI 1023415395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669542858 NPI number — MS. PAULETTE M. CHARTIER APRN, BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHARTIER
Provider First Name:
PAULETTE
Provider Middle Name:
M.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, BC
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:
1669542858
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
52 BRIGHAM ST STE 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02740-2210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-993-8332
Provider Business Mailing Address Fax Number:
508-993-1024

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
52 BRIGHAM ST STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-2210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-993-8332
Provider Business Practice Location Address Fax Number:
508-993-1024
Provider Enumeration Date:
11/08/2006

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: 363LP0808X , with the licence number:  138489 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 410549 . This is a "BLUE CHIP OF RHODE ISLAND" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 778941 . This is a "TUFTS HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: PN0715 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 256702 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AO24199 . This is a "HARVARDPILGRIM HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000022412 . This is a "BOSTON MEDICAL HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 22844-001 . This is a "BC BS OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: VALUE OPTIONS . This is a "003771" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1030320 . This is a "BEACON HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1892541 . This is a "BEH. HEALTH PARTNERSHIP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0061-01 . This is a "PACIFICARE BEHAVIORAL HLT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1851306 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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