1063503241 NPI number — MR. EDMOND LOUIS DEGAIFFIER MSW, LICSW, LCSW-C

Table of content: MR. EDMOND LOUIS DEGAIFFIER MSW, LICSW, LCSW-C (NPI 1063503241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063503241 NPI number — MR. EDMOND LOUIS DEGAIFFIER MSW, LICSW, LCSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEGAIFFIER
Provider First Name:
EDMOND
Provider Middle Name:
LOUIS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LICSW, LCSW-C
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:
1063503241
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 E ST SE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20003-2620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-297-1700
Provider Business Mailing Address Fax Number:
202-543-2232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 E ST SE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20003-2620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-297-1700
Provider Business Practice Location Address Fax Number:
202-543-2232
Provider Enumeration Date:
09/27/2006

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:  LC303481 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 11102 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com