1295968519 NPI number — NORMAN WILLIAM JASMUND MSW, LMSW

Table of content: NORMAN WILLIAM JASMUND MSW, LMSW (NPI 1295968519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295968519 NPI number — NORMAN WILLIAM JASMUND MSW, LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JASMUND
Provider First Name:
NORMAN
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LMSW
Provider Gender Code:
M

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:
1295968519
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 W EXCHANGE ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
OWOSSO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48867-2834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-723-8239
Provider Business Mailing Address Fax Number:
989-723-8230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 W. EXCHANGE STREET
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
OWOSSO
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48867
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-723-8239
Provider Business Practice Location Address Fax Number:
989-723-8230
Provider Enumeration Date:
09/03/2009

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:  6801017387 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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