1013925213 NPI number — MS. JANE HUNDLEY LCSW

Table of content: MS. JANE HUNDLEY LCSW (NPI 1013925213)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013925213 NPI number — MS. JANE HUNDLEY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNDLEY
Provider First Name:
JANE
Provider Middle Name:
Provider Name Prefix Text:
MS.
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:
1013925213
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1309 HARVEST RIDGE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLACKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24060-5068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-529-6882
Provider Business Mailing Address Fax Number:
540-962-3705

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1309 HARVEST RIDGE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLACKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24060-5068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-529-6882
Provider Business Practice Location Address Fax Number:
540-926-3705
Provider Enumeration Date:
08/03/2006

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: 1041C0700X , with the licence number:  0904000704 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 010052165 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 088514 . This is a "SENTARA, SOUTHERN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102089000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2123627 . This is a "MAMSI, MDIPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 091293 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5419250036 . This is a "UHC/UBH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4602401 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 115112 . This is a "ANTHEM, ANTHEM HEALTHKEEP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com