1700815040 NPI number — CATHERINE L LACOSTE-HAMEL APRN, BC

Table of content: CATHERINE L LACOSTE-HAMEL APRN, BC (NPI 1700815040)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700815040 NPI number — CATHERINE L LACOSTE-HAMEL APRN, BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LACOSTE-HAMEL
Provider First Name:
CATHERINE
Provider Middle Name:
L
Provider Name Prefix Text:
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:
1700815040
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1082 DAVOL ST
Provider Second Line Business Mailing Address:
ARBOUR COUNSELING SERVICES
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-678-2388
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1082 DAVOL ST
Provider Second Line Business Practice Location Address:
ARBOUR COUNSELING SERVICES
Provider Business Practice Location Address City Name:
FALL RIVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-678-2388
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2006

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: 364SP0807X , with the licence number:  PNS00006 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364SP0807X , with the licence number: 003703 , 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: 30172-5 . This is a "BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 407841 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 004037032 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 62-01668 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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