1952362162 NPI number — DENISE A ESTILL LISW-S

Table of content: DENISE A ESTILL LISW-S (NPI 1952362162)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952362162 NPI number — DENISE A ESTILL LISW-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESTILL
Provider First Name:
DENISE
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LISW-S
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:
1952362162
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2845 BELL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ZANESVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43701-1720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-454-9766
Provider Business Mailing Address Fax Number:
740-588-6452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
710 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COSHOCTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43812-1615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-622-4470
Provider Business Practice Location Address Fax Number:
740-622-5580
Provider Enumeration Date:
03/29/2006

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:  I9557 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 543521000 . This is a "MAGELLAN PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 5773 . This is a "FEI BH PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: Y543521 . This is a "THE HEALTH PLAN PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7594528 . This is a "AETNA PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000340446 . This is a "ANTHEM PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 307822 . This is a "TRICARE/MHN PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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