1821324013 NPI number — MRS. ALYSON GATES L.C.S.W

Table of content: MRS. ALYSON GATES L.C.S.W (NPI 1821324013)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821324013 NPI number — MRS. ALYSON GATES L.C.S.W

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GATES
Provider First Name:
ALYSON
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W
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:
1821324013
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CHRISTIANA COUNSELING AND PSYCHIATRIC ASSOCIATES
Provider Second Line Business Mailing Address:
5235 WEST WOODMILL DRIVE, SUITE 47
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-995-1680
Provider Business Mailing Address Fax Number:
302-995-1790

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5235 WEST WOODMILL DRIVE, SUITE 47
Provider Second Line Business Practice Location Address:
CHRISTIANA COUNSELING AND PSYCHIATRIC ASSOCIATES
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-995-1680
Provider Business Practice Location Address Fax Number:
302-995-1790
Provider Enumeration Date:
10/23/2009

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: 1041C0700X , with the licence number:  Q1-0000992 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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