1801501556 NPI number — NORTHBOUND COUNSELING

Table of content: VASUDA BANGALORE KROELINGER BCBA, LBA (NPI 1699224840)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801501556 NPI number — NORTHBOUND COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHBOUND COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1801501556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 DODGE STREET UNIT C
Provider Second Line Business Mailing Address:
#1001
Provider Business Mailing Address City Name:
BVERLY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01915
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-219-6798
Provider Business Mailing Address Fax Number:
978-626-3786

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 DODGE STREET UNIT C
Provider Second Line Business Practice Location Address:
#1001
Provider Business Practice Location Address City Name:
BEVERLY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-219-6798
Provider Business Practice Location Address Fax Number:
978-626-3786
Provider Enumeration Date:
01/17/2023

Additional Information

Authorized Official

Authorized Official Last Name:
COLBERT
Authorized Official First Name:
JOSIAH
Authorized Official Middle Name:
DANIEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
978-880-2818

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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