1891872156 NPI number — MS. MARSHA ILENE SCHECHTMAN LCSW

Table of content: MS. MARSHA ILENE SCHECHTMAN LCSW (NPI 1891872156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891872156 NPI number — MS. MARSHA ILENE SCHECHTMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHECHTMAN
Provider First Name:
MARSHA
Provider Middle Name:
ILENE
Provider Name Prefix Text:
MS.
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:
1891872156
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
295 W CROSSVILLE RD
Provider Second Line Business Mailing Address:
SUITE 740
Provider Business Mailing Address City Name:
ROSWELL
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30075-6231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-753-4911
Provider Business Mailing Address Fax Number:
678-205-0337

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
295 W CROSSVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 740
Provider Business Practice Location Address City Name:
ROSWELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30075-6231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-753-4911
Provider Business Practice Location Address Fax Number:
678-205-0337
Provider Enumeration Date:
11/01/2006

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:  CSW000392 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com