1841435112 NPI number — MRS. EVELINE LIBBY HEJNY LCSW

Table of content: MRS. EVELINE LIBBY HEJNY LCSW (NPI 1841435112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841435112 NPI number — MRS. EVELINE LIBBY HEJNY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEJNY
Provider First Name:
EVELINE
Provider Middle Name:
LIBBY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1841435112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13840 CHAMY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89521-7356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-851-2388
Provider Business Mailing Address Fax Number:
775-688-0486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 MEDICAL PKWY
Provider Second Line Business Practice Location Address:
BEHAVIORAL HEALTH SERVICES
Provider Business Practice Location Address City Name:
CARSON CITY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-885-4460
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/15/2008

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: 1041C0700X , with the licence number:  2237-C , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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