1851427223 NPI number — MS. VICTORIA ANN FERNANDEZ LMSW

Table of content: MS. VICTORIA ANN FERNANDEZ LMSW (NPI 1851427223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851427223 NPI number — MS. VICTORIA ANN FERNANDEZ LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ
Provider First Name:
VICTORIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORESI
Provider Other First Name:
VICTORIA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851427223
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44658 BAYVIEW AVE
Provider Second Line Business Mailing Address:
#10105
Provider Business Mailing Address City Name:
CLINTON TOWNSHIP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48038-7024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-907-0069
Provider Business Mailing Address Fax Number:
586-948-0213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44658 BAYVIEW AVE
Provider Second Line Business Practice Location Address:
#10105
Provider Business Practice Location Address City Name:
CLINTON TOWNSHIP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48038-7024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-907-0069
Provider Business Practice Location Address Fax Number:
586-948-0213
Provider Enumeration Date:
02/27/2007

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: 251S00000X , with the licence number:  6801071796 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 6801071796 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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