1275689044 NPI number — MARGARET STUMP LMFT

Table of content: MARGARET STUMP LMFT (NPI 1275689044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275689044 NPI number — MARGARET STUMP LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STUMP
Provider First Name:
MARGARET
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
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:
1275689044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
610 N BROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANKATO
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56001-3423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-344-1894
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 S 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT PETER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56082-2043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-931-8040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/26/2007

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: 106H00000X , with the licence number:  1424 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1047165 . This is a "PREFERRED ONE INDIV #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP61524 . This is a "HEALTH PARTNERS INDIV #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 078H3ST . This is a "BCBS INDIVIDUAL #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 113647 . This is a "UCARE INDIVIDUAL #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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