1730227174 NPI number — MS. ASHLEY M. PAXTON-WATTS LCSW

Table of content: MS. ASHLEY M. PAXTON-WATTS LCSW (NPI 1730227174)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730227174 NPI number — MS. ASHLEY M. PAXTON-WATTS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAXTON-WATTS
Provider First Name:
ASHLEY
Provider Middle Name:
M.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAXTON-WATTS
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1730227174
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1028 ARBOR HILL CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34715-8187
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-874-6574
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1028 ARBOR HILL CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34715-8187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-874-6574
Provider Business Practice Location Address Fax Number:
352-874-6574
Provider Enumeration Date:
02/01/2007

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: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 024191300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com