1144302076 NPI number — MS. LYNDA S WARNER L.C.S.W.

Table of content: MS. LYNDA S WARNER L.C.S.W. (NPI 1144302076)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144302076 NPI number — MS. LYNDA S WARNER L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARNER
Provider First Name:
LYNDA
Provider Middle Name:
S
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:
1144302076
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
312 B ST SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ABINGDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24210-3712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-628-1664
Provider Business Mailing Address Fax Number:
276-628-9875

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
188 E MAIN ST STE 1A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ABINGDON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24210-2857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-628-1664
Provider Business Practice Location Address Fax Number:
276-628-9875
Provider Enumeration Date:
10/19/2006

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:  0904000414 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 54-173774509 . This is a "JOHN DEERE/UNITED BEHAVIO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: CP . This is a "CORPORATE FAMILY NETWORKE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 061984 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 254565000 . This is a "MAGELLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8931119/DNS , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CP . This is a "CHOICE CARE/HUMANA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 034778 . This is a "VALUE OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 344077 . This is a "MAMSI/OPTIMUM CHOICE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4036400 . This is a "BCBS OF TENNESSEE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 423995 . This is a "CCN COMMUNITY CARE NETWOR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: AR . This is a "CIGNAPPO/CIGNA BH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 54-173774509 . This is a "HERITAGE NATIONAL HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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