1972382281 NPI number — FIDELITY FAMILY THERAPY AND CONSULTING

Table of content: DR. THOMAS JOHN GIANIS II M.D. (NPI 1467895375)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972382281 NPI number — FIDELITY FAMILY THERAPY AND CONSULTING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIDELITY FAMILY THERAPY AND CONSULTING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1972382281
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1155 MARKET ST NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97301-1135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-871-2330
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 HIGH ST SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97301-3613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
971-600-1603
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2023

Additional Information

Authorized Official

Authorized Official Last Name:
DAVID
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
503-871-2330

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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