1306239348 NPI number — PROGRESS IN MOTION PLLC

Table of content: ESTELA MARIA MERCED LMHC (NPI 1326792417)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306239348 NPI number — PROGRESS IN MOTION PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROGRESS IN MOTION PLLC
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:
1306239348
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7910 KINGSTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAXHAW
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28173-9002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
980-218-0515
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7910 KINGSTON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAXHAW
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28173-9002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-218-0515
Provider Business Practice Location Address Fax Number:
980-265-0015
Provider Enumeration Date:
03/16/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SYMONS
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DIRECTOR
Authorized Official Telephone Number:
616-560-9593

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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