1174799811 NPI number — ANNIE DAWN HADGKISS LPC

Table of content: ANNIE DAWN HADGKISS LPC (NPI 1174799811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174799811 NPI number — ANNIE DAWN HADGKISS LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HADGKISS
Provider First Name:
ANNIE
Provider Middle Name:
DAWN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HADGKISS
Provider Other First Name:
DAWN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1174799811
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3518 DRAWBRIDGE PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27410-8432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-337-5050
Provider Business Mailing Address Fax Number:
336-282-3079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3518 DRAWBRIDGE PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27410-8432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-337-5050
Provider Business Practice Location Address Fax Number:
336-282-3079
Provider Enumeration Date:
05/02/2008

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: 101YM0800X , with the licence number:  4185 , 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)