1215079413 NPI number — MRS. DOROTHY JEAN MULLINEAUX SAUER LCSWR

Table of content: MRS. DOROTHY JEAN MULLINEAUX SAUER LCSWR (NPI 1215079413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215079413 NPI number — MRS. DOROTHY JEAN MULLINEAUX SAUER LCSWR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MULLINEAUX SAUER
Provider First Name:
DOROTHY
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
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:
MULLINEAUX SAUER
Provider Other First Name:
DOTTIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1215079413
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 CHELSEA PLACE
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
CLIFTON PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-526-1151
Provider Business Mailing Address Fax Number:
518-383-3249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 CHELSEA PLACE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
CLIFTON PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-526-1151
Provider Business Practice Location Address Fax Number:
518-383-3246
Provider Enumeration Date:
02/13/2007

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:  R031156 , 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)





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