1083625438 NPI number — MS. STACEY ARNETT PRICE-LEWIS MSW,CMSW

Table of content: MS. STACEY ARNETT PRICE-LEWIS MSW,CMSW (NPI 1083625438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083625438 NPI number — MS. STACEY ARNETT PRICE-LEWIS MSW,CMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRICE-LEWIS
Provider First Name:
STACEY
Provider Middle Name:
ARNETT
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW,CMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PRICE
Provider Other First Name:
STACEY
Provider Other Middle Name:
ARNETT
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW,CMSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083625438
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9305 STATE LINE RD
Provider Second Line Business Mailing Address:
APT. 23 F
Provider Business Mailing Address City Name:
OLIVE BRANCH
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38654-3727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-870-6971
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1030 JEFFERSON AVE
Provider Second Line Business Practice Location Address:
VAMC SOCIAL WORK SERVICE
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38104-2127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-523-8990
Provider Business Practice Location Address Fax Number:
901-577-7427
Provider Enumeration Date:
08/11/2006

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: 104100000X , with the licence number:  CSW0000006617 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CSW0000006617 . This is a "CMSW LICENCE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com