1356650121 NPI number — MRS. KATHLEEN MCFADDEN MYERS LCPC

Table of content: MRS. KATHLEEN MCFADDEN MYERS LCPC (NPI 1356650121)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356650121 NPI number — MRS. KATHLEEN MCFADDEN MYERS LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCFADDEN MYERS
Provider First Name:
KATHLEEN
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCFADDEN
Provider Other First Name:
KATHLEEN
Provider Other Middle Name:
JANA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356650121
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
416 WILLIAM PLUMMER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW MARKET
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21774-6516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-800-2569
Provider Business Mailing Address Fax Number:
866-800-2569

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 W CHURCH ST
Provider Second Line Business Practice Location Address:
SUITE 2-D
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21701-7800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-800-2569
Provider Business Practice Location Address Fax Number:
866-800-2569
Provider Enumeration Date:
09/28/2010

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: 101YP2500X , with the licence number:  LC3663 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com