1285903971 NPI number — CENTRE POINTE HEALTH - PSYCHOLOGICAL SERVICES

Table of content: DR. MICHAEL MUELLER PH.D., BCBA (NPI 1437383155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285903971 NPI number — CENTRE POINTE HEALTH - PSYCHOLOGICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRE POINTE HEALTH - PSYCHOLOGICAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1285903971
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3920 PLANK RD
Provider Second Line Business Mailing Address:
120
Provider Business Mailing Address City Name:
FREDERICKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22407-7104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-446-0327
Provider Business Mailing Address Fax Number:
540-786-2396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3920 PLANK RD
Provider Second Line Business Practice Location Address:
120
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22407-7104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-446-0327
Provider Business Practice Location Address Fax Number:
540-786-2396
Provider Enumeration Date:
12/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
JOSEPH
Authorized Official First Name:
CHERIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
540-735-7112

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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