1912969411 NPI number — PATRICIA INGHRAM CURTIS LMHC

Table of content: PATRICIA INGHRAM CURTIS LMHC (NPI 1912969411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912969411 NPI number — PATRICIA INGHRAM CURTIS LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CURTIS
Provider First Name:
PATRICIA
Provider Middle Name:
INGHRAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
INGHRAM
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912969411
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
719 JADWIN AVE # 16
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHLAND
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99352-4217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-943-7016
Provider Business Mailing Address Fax Number:
509-943-2129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
719 JADWIN AVE
Provider Second Line Business Practice Location Address:
SUITE 16
Provider Business Practice Location Address City Name:
RICHLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99352-4217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-943-7016
Provider Business Practice Location Address Fax Number:
509-967-4754
Provider Enumeration Date:
04/03/2006

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: 101YM0800X , with the licence number:  LH00007538 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 890-2874 . This is a "CRIME VICTIMS/L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: LH00007538 . This is a "LICENSED COUNSELOR" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 202213578-99352 . This is a "TRI-CARE/TRI-WEST" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 2211205 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com