1104046531 NPI number — MS. VALERIE M LEYTON LCMHC

Table of content: MS. VALERIE M LEYTON LCMHC (NPI 1104046531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104046531 NPI number — MS. VALERIE M LEYTON LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEYTON
Provider First Name:
VALERIE
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEYTON
Provider Other First Name:
VALERIE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCMHC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1104046531
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 WEST HOLLIS ST
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
NASHUA
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03062-1387
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-889-2843
Provider Business Mailing Address Fax Number:
603-889-2803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 WEST HOLLIS ST
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03062-1387
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-889-2843
Provider Business Practice Location Address Fax Number:
603-889-2803
Provider Enumeration Date:
04/26/2007

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

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

  • Identifier: 30423495 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com