1336374495 NPI number — MISS CYNTHIA NICOLE LAWSON CMHT

Table of content: MISS CYNTHIA NICOLE LAWSON CMHT (NPI 1336374495)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336374495 NPI number — MISS CYNTHIA NICOLE LAWSON CMHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWSON
Provider First Name:
CYNTHIA
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
CMHT
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:
1336374495
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 N CONGRESS ST STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39201-1902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-371-1809
Provider Business Mailing Address Fax Number:
601-376-0088

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 N CONGRESS ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39201-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-371-1809
Provider Business Practice Location Address Fax Number:
601-376-0088
Provider Enumeration Date:
05/19/2009

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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