1770712341 NPI number — SARAH KATE SEAGRAVE MA MHC AND ET

Table of content: MISS KATARZYNA DLUGOSZ MPSY, CASAC, LMHC (NPI 1699939991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770712341 NPI number — SARAH KATE SEAGRAVE MA MHC AND ET

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEAGRAVE
Provider First Name:
SARAH
Provider Middle Name:
KATE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA MHC AND ET
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:
1770712341
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45 SUMMER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEOMINSTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01453-3228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-977-5555
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 SUMMER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEOMINSTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01453-3228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-977-5555
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2009

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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