1124360516 NPI number — ANTOINETTE LANCASTER LPC, NCC, MAC

Table of content: NAOMI STANSBERRY (NPI 1871386581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124360516 NPI number — ANTOINETTE LANCASTER LPC, NCC, MAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANCASTER
Provider First Name:
ANTOINETTE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC, NCC, MAC
Provider Gender Code:
F

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:
1124360516
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14303 KENLON LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ACCOKEEK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20607-3745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-388-7795
Provider Business Mailing Address Fax Number:
240-388-7795

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1629 K ST NW
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:
20006-1602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-239-5563
Provider Business Practice Location Address Fax Number:
240-204-8153
Provider Enumeration Date:
03/23/2013

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: 101YA0400X , with the licence number:  CACII1131 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: PRC14152 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: LC5764 , 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)