1750544524 NPI number — MS. CONNIE MARIE WEST MS LPCI

Table of content: MS. CONNIE MARIE WEST MS LPCI (NPI 1750544524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750544524 NPI number — MS. CONNIE MARIE WEST MS LPCI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEST
Provider First Name:
CONNIE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS LPCI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOBDY
Provider Other First Name:
CONNIE
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS LPCI
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750544524
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3001 HAMILTON CHURCH RD
Provider Second Line Business Mailing Address:
UNIT 307
Provider Business Mailing Address City Name:
ANTIOCH
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37013-7401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-867-6000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3400 LEBANON ROAD
Provider Second Line Business Practice Location Address:
ALVIN C YORK CAMPUS DEPARTMENT OF VETERAN AFFAIRS
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37129-1237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-867-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2008

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:  60284 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 60284 . This is a "STATE OF TEXAS TEMP COUNSELOR LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".