1750456992 NPI number — DR. KIMBERLY SHAY LITTON-BELCHER PSY.D.

Table of content: ABIGAIL MARIE KUKAY MS (NPI 1912793217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750456992 NPI number — DR. KIMBERLY SHAY LITTON-BELCHER PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LITTON-BELCHER
Provider First Name:
KIMBERLY
Provider Middle Name:
SHAY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSY.D.
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:
1750456992
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
920 ALEPPO DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LADSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29456-3114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-963-6605
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CMR 463 BOX 92
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KATTERBACH
Provider Business Practice Location Address State Name:
GERMANY
Provider Business Practice Location Address Postal Code:
APO AE 09177
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
843-469-7120
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2006

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: 101YM0800X , with the licence number:  178004324 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: 071.007662 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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