1184732513 NPI number — MRS. LINDIA JEAN KELLY-STROMAN SOCIAL WORKER

Table of content: MRS. LINDIA JEAN KELLY-STROMAN SOCIAL WORKER (NPI 1184732513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184732513 NPI number — MRS. LINDIA JEAN KELLY-STROMAN SOCIAL WORKER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KELLY-STROMAN
Provider First Name:
LINDIA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SOCIAL WORKER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KELLY
Provider Other First Name:
LINDIA
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
SOCIAL WORKER
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184732513
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
FRIEDBERG HEALTH CLINIC
Provider Second Line Business Mailing Address:
CMR 453
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09074
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
4906031813204
Provider Business Mailing Address Fax Number:
4906031813161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ATTN: CREDENTIALS OFFICE
Provider Second Line Business Practice Location Address:
CMR 442
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09042
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
496221172274
Provider Business Practice Location Address Fax Number:
496221172941
Provider Enumeration Date:
08/27/2006

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:  6801077599/1745623 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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