1932148558 NPI number — MARY HUTCHISON LCSW

Table of content: MARY HUTCHISON LCSW (NPI 1932148558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932148558 NPI number — MARY HUTCHISON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUTCHISON
Provider First Name:
MARY
Provider Middle Name:
Provider Name Prefix Text:
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:
1932148558
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RR 4 BOX 4515
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PIEDMONT
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63957-9417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-223-4233
Provider Business Mailing Address Fax Number:
573-223-2136

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RR 4 BOX 4515
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIEDMONT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63957-9417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-223-4233
Provider Business Practice Location Address Fax Number:
573-223-2136
Provider Enumeration Date:
06/06/2006

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:  000907 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2078586 . This is a "FIRST HEALTH/COVENTRY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 494975212 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2255 . This is a "EAP IMPACT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 179816 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 431116734 . This is a "EAP CONCERN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 431116734 . This is a "NEW DIRECTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 431116734 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11333395 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 431116734 . This is a "EAP PEOPLE RESOURCES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 431116734 . This is a "EAP INTERFACE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 713315 . This is a "HEALTHLINK PPO" identifier . This identifiers is of the category "OTHER".




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