1346265865 NPI number — JOANNE MAYER MSSA, LISW-S, LCSW

Table of content: JOANNE MAYER MSSA, LISW-S, LCSW (NPI 1346265865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346265865 NPI number — JOANNE MAYER MSSA, LISW-S, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAYER
Provider First Name:
JOANNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSSA, LISW-S, LCSW
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:
1346265865
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1005 W 9TH AVE STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KING OF PRUSSIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19406-1202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 W 9TH AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KING OF PRUSSIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19406-1202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-892-3800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2006

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:  I-0008960 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CW018672 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000333459 . This is a "ANTHEM PIN NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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