1023386364 NPI number — MS. CARMEN-ECATERINA VISAN LMHC

Table of content: MS. CARMEN-ECATERINA VISAN LMHC (NPI 1023386364)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023386364 NPI number — MS. CARMEN-ECATERINA VISAN LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VISAN
Provider First Name:
CARMEN-ECATERINA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VISAN
Provider Other First Name:
CARMEN
Provider Other Middle Name:
ECATERINA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
N/A
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023386364
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
421 N PEARL ST
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
ELLENSBURG
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98926-3193
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-925-2114
Provider Business Mailing Address Fax Number:
509-925-2115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
421 N PEARL ST
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-3193
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-925-2114
Provider Business Practice Location Address Fax Number:
509-925-2115
Provider Enumeration Date:
12/01/2011

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:  LH 60202825 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com