1992982474 NPI number — NEW PERSPECTIVES COUNSELING AND CONSULTATION PLLC

Table of content: (NPI 1992982474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992982474 NPI number — NEW PERSPECTIVES COUNSELING AND CONSULTATION PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW PERSPECTIVES COUNSELING AND CONSULTATION PLLC
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:
1992982474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4082
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOORESVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28117-4082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-706-4528
Provider Business Mailing Address Fax Number:
704-749-8612

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
903 NORTHEAST DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
DAVIDSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28036-7416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-704-4528
Provider Business Practice Location Address Fax Number:
704-749-8612
Provider Enumeration Date:
01/27/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FORTE
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
LESLIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
704-706-4528

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  C005323 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6006397 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".