1023180593 NPI number — MS. LESLIE ANN ANDREW L.M.H.P. C.M.S.W.

Table of content: (NPI 1013128032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023180593 NPI number — MS. LESLIE ANN ANDREW L.M.H.P. C.M.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDREW
Provider First Name:
LESLIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.M.H.P. C.M.S.W.
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:
1023180593
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7847 STONEWALL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68506-4172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-432-3317
Provider Business Mailing Address Fax Number:
402-486-4992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7847 STONEWALL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68506-4172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-432-3317
Provider Business Practice Location Address Fax Number:
402-486-4992
Provider Enumeration Date:
11/14/2006

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: 101YM0800X , with the licence number:  702 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 583 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 071342 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10025203100 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 784682000 . This is a "MAGELLAN" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 85213 . This is a "BCBS OF NE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 261192170 . This is a "UBH" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 784682000 . This is a "MIS NUMBER" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 83060 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 90025 . This is a "BCBS SUPERVISING NUMBER" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 911747525 . This is a "CHAMPUS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 911747525 . This is a "UBH" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 4380 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10025568800 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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