1285837294 NPI number — MS. CASSANDRA PATTERSON HOSKINS MS, LPC

Table of content: MS. CASSANDRA PATTERSON HOSKINS MS, LPC (NPI 1285837294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285837294 NPI number — MS. CASSANDRA PATTERSON HOSKINS MS, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOSKINS
Provider First Name:
CASSANDRA
Provider Middle Name:
PATTERSON
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOSKINS
Provider Other First Name:
CASSANDRA
Provider Other Middle Name:
PATTERSON
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1285837294
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1702 S SIDE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27406-3119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-339-3824
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 W MEADOWVIEW RD
Provider Second Line Business Practice Location Address:
SUITE203
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27407-3723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-339-3824
Provider Business Practice Location Address Fax Number:
888-502-5943
Provider Enumeration Date:
06/07/2007

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: 101YP2500X , with the licence number:  6586 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 14571 . This is a "BLUECROSS BLUESHIELD OF NORTH CAROLINA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 6103614 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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