1669874996 NPI number — MRS. VIRGINIA YORK LPCC

Table of content: MRS. VIRGINIA YORK LPCC (NPI 1669874996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669874996 NPI number — MRS. VIRGINIA YORK LPCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YORK
Provider First Name:
VIRGINIA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPCC
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:
1669874996
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3000 ARLINGTON AVE
Provider Second Line Business Mailing Address:
MS 1161
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43614-2595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-383-3861
Provider Business Mailing Address Fax Number:
419-383-3289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3000 ARLINGTON AVE
Provider Second Line Business Practice Location Address:
MS 1161
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43614-2595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-383-3861
Provider Business Practice Location Address Fax Number:
419-383-3289
Provider Enumeration Date:
09/18/2014

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: 101YM0800X , with the licence number:  E.2102232 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: C 1300170 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 398232 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: C 1300170 . This is a "OHIO COUNSELOR AND SOCIAL WORK BOARD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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