1144229576 NPI number — MS. LINDA SUSAN MCALISTER L.C.S.W.

Table of content: MS. LINDA SUSAN MCALISTER L.C.S.W. (NPI 1144229576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144229576 NPI number — MS. LINDA SUSAN MCALISTER L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCALISTER
Provider First Name:
LINDA
Provider Middle Name:
SUSAN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
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:
1144229576
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 OAKMONT CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BERN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28562-4962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-634-3459
Provider Business Mailing Address Fax Number:
252-636-0200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1912A TRENT BLVD
Provider Second Line Business Practice Location Address:
OFFICE 3
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28560-4500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-636-0200
Provider Business Practice Location Address Fax Number:
252-636-0200
Provider Enumeration Date:
07/18/2005

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:  C003339 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 130C8 . This is a "BCBS OF NC PROVIDER NUMBE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 6002275 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 564704 . This is a "TRICARE PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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