1033206958 NPI number — MR. JAMES CHRISTOPHER MCNERNEY L.C.S.W.

Table of content: MR. JAMES CHRISTOPHER MCNERNEY L.C.S.W. (NPI 1033206958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033206958 NPI number — MR. JAMES CHRISTOPHER MCNERNEY L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNERNEY
Provider First Name:
JAMES
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
M

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:
1033206958
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1061 HARMON AVE
Provider Second Line Business Mailing Address:
STE1D03
Provider Business Mailing Address City Name:
FORT STEWART
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31314-5674
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1061 HARMON AVE
Provider Second Line Business Practice Location Address:
STE1D03
Provider Business Practice Location Address City Name:
FORT STEWART
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31314-5674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-767-7301
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2006

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:  CSW003484 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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