1871529420 NPI number — SHARON MARIE CHESTER LCSW-BACS

Table of content: SHARON MARIE CHESTER LCSW-BACS (NPI 1871529420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871529420 NPI number — SHARON MARIE CHESTER LCSW-BACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHESTER
Provider First Name:
SHARON
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW-BACS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARTHEW
Provider Other First Name:
SHARON
Provider Other Middle Name:
MARIE
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:
1871529420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1519 E JUDGE PEREZ DR
Provider Second Line Business Mailing Address:
SUITE 5
Provider Business Mailing Address City Name:
CHALMETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70043-5569
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-982-7466
Provider Business Mailing Address Fax Number:
504-272-0758

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1519 E JUDGE PEREZ DR
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
CHALMETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70043-5569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-982-7466
Provider Business Practice Location Address Fax Number:
504-272-0758
Provider Enumeration Date:
06/24/2006

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:  1748 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3B486 . This is a "MEDICARE PTAN" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 2170066 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".