1184702003 NPI number — MS. BEVERLY ANN STARMAN LCSW

Table of content: (NPI 1275191025)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184702003 NPI number — MS. BEVERLY ANN STARMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STARMAN
Provider First Name:
BEVERLY
Provider Middle Name:
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:
1184702003
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3300 N 60TH ST
Provider Second Line Business Mailing Address:
CATHOLIC CHARITIES OF OMAHA
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68104-3402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-829-9258
Provider Business Mailing Address Fax Number:
402-551-8797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3020 18TH ST.
Provider Second Line Business Practice Location Address:
STE 17
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68601-4254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-562-8714
Provider Business Practice Location Address Fax Number:
402-370-3373
Provider Enumeration Date:
11/01/2006

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: 103TC0700X , with the licence number:  1078 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 2609 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 85274 . This is a "BCBS PPO" identifier . This identifiers is of the category "OTHER".




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