1295860963 NPI number — MOLLY ALENE MCLAUGHLIN OTR/L, MA COUNSELING

Table of content: MOLLY ALENE MCLAUGHLIN OTR/L, MA COUNSELING (NPI 1295860963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295860963 NPI number — MOLLY ALENE MCLAUGHLIN OTR/L, MA COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLAUGHLIN
Provider First Name:
MOLLY
Provider Middle Name:
ALENE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L, MA COUNSELING
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:
1295860963
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1650 UNIVERSITY BLVD NE
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87102-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-272-8950
Provider Business Mailing Address Fax Number:
505-272-3202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 MENAUL BLVD NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87107-1851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-8950
Provider Business Practice Location Address Fax Number:
505-272-3202
Provider Enumeration Date:
02/22/2007

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: 101Y00000X , with the licence number:  0103921 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X , with the licence number: 401 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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