1063500189 NPI number — ASSOCIATED PSYCHOLOGISTS & COUNSELORS, LLC

Table of content: MS. PAULA DAWN EVANS 2 MASTER OF ARTS DEG (NPI 1740475375)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063500189 NPI number — ASSOCIATED PSYCHOLOGISTS & COUNSELORS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATED PSYCHOLOGISTS & COUNSELORS, LLC
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:
1063500189
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1306 N 13TH ST
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68701-2591
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-371-8218
Provider Business Mailing Address Fax Number:
402-371-8259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1306 N 13TH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68701-2591
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-371-8218
Provider Business Practice Location Address Fax Number:
402-371-8259
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CURRAN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT/PSYCHOLOGIST
Authorized Official Telephone Number:
402-371-8218

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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