1164688487 NPI number — MS. NICOLE MARGRIT-ANN KEESEE LCSW

Table of content: MS. NICOLE MARGRIT-ANN KEESEE LCSW (NPI 1164688487)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164688487 NPI number — MS. NICOLE MARGRIT-ANN KEESEE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEESEE
Provider First Name:
NICOLE
Provider Middle Name:
MARGRIT-ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1164688487
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 NORTH VEITCH STREER
Provider Second Line Business Mailing Address:
APT 404
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22201-7059
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-601-0692
Provider Business Mailing Address Fax Number:
703-601-0801

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2400 ARMY PENTAGON DRIVE
Provider Second Line Business Practice Location Address:
DAAR-MD
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20310-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-601-0692
Provider Business Practice Location Address Fax Number:
703-601-0801
Provider Enumeration Date:
08/06/2008

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:  849-C , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com