1841340684 NPI number — JEAN S. KURTZ RN, MA, LPC

Table of content: JEAN S. KURTZ RN, MA, LPC (NPI 1841340684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841340684 NPI number — JEAN S. KURTZ RN, MA, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KURTZ
Provider First Name:
JEAN
Provider Middle Name:
S.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MA, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEINGASS
Provider Other First Name:
JEANNE
Provider Other Middle Name:
LACEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841340684
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 PARK VIEW LN STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHEELING
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26003-5406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-281-3652
Provider Business Mailing Address Fax Number:
844-266-2411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 PARK VIEW LN STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHEELING
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26003-5406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-281-3652
Provider Business Practice Location Address Fax Number:
844-266-2411
Provider Enumeration Date:
01/12/2007

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:  1821 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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