1174110183 NPI number — MISS ANDREA COURTNEY PARIS LAYNE LMHC

Table of content: MISS ANDREA COURTNEY PARIS LAYNE LMHC (NPI 1174110183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174110183 NPI number — MISS ANDREA COURTNEY PARIS LAYNE LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAYNE
Provider First Name:
ANDREA
Provider Middle Name:
COURTNEY PARIS
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COURTNEY
Provider Other First Name:
ANDREA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
TLMHC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174110183
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1825 CALEB CT UNIT 107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH LIBERTY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52317-8848
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-759-3967
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 E WASHINGTON ST STE 305A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-3928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
506-931-9849
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/23/2020

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:  100474 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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