1679807937 NPI number — MRS. DIANE C NEUMAN M.A., LMFT

Table of content: MRS. DIANE C NEUMAN M.A., LMFT (NPI 1679807937)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679807937 NPI number — MRS. DIANE C NEUMAN M.A., LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEUMAN
Provider First Name:
DIANE
Provider Middle Name:
C
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., LMFT
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:
1679807937
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
56 BEACH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE EGG HARBOR TWP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08087-1002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-709-9955
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
125 E MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
TUCKERTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08087-2669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-709-9955
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/18/2009

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: 106H00000X , with the licence number:  37FI00160700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: MF000160 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: MF000160 . This is a "PENNSYLVANIA MARRIAGE AND FAMILY THERAPY LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 37FI00160700 . This is a "NEW JERSEY MARRIAGE AND FAMILY LICENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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