1184783946 NPI number — MS. SUSAN DIANE PIOWATY LCSWR

Table of content: MS. SUSAN DIANE PIOWATY LCSWR (NPI 1184783946)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184783946 NPI number — MS. SUSAN DIANE PIOWATY LCSWR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIOWATY
Provider First Name:
SUSAN
Provider Middle Name:
DIANE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSWR
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:
1184783946
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 SPRINGTOWN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW PALTZ
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12561-3025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-256-1515
Provider Business Mailing Address Fax Number:
845-256-1515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
127 SPRINGTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW PALTZ
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12561-3025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-256-1515
Provider Business Practice Location Address Fax Number:
845-256-1515
Provider Enumeration Date:
12/07/2006

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:  039916 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 107576 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 324504 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10057773 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2153623 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 137122 . This is a "VALUE OPTIONS GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7932322 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 279743000 . This is a "MEGELLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00495189002 . This is a "BLUE SHIELD OF NE NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7480508 . This is a "VALUE OPTIONS EMPIRE PLA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2186230 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: R039916 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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