1205992336 NPI number — MS. DIANE T RIOPELLE MSW

Table of content: MS. DIANE T RIOPELLE MSW (NPI 1205992336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205992336 NPI number — MS. DIANE T RIOPELLE MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIOPELLE
Provider First Name:
DIANE
Provider Middle Name:
T
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
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:
1205992336
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24 ANDRESKI DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREMONT
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03044-3020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-590-9367
Provider Business Mailing Address Fax Number:
978-372-6173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 ANDRESKI DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREMONT
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03044-3020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-590-9367
Provider Business Practice Location Address Fax Number:
978-372-6173
Provider Enumeration Date:
01/01/2007

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:  110726 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 476459000 . This is a "MAGELLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P07898 . This is a "BC&BS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1858149 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2169428 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110032000A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3126959 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1030500 . This is a "BEACON HEALTH STRATEGIES" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7815382 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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