1376731281 NPI number — MRS. JENNIFER ANDERSON MCNAUGHT LPC

Table of content: MRS. JENNIFER ANDERSON MCNAUGHT LPC (NPI 1376731281)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376731281 NPI number — MRS. JENNIFER ANDERSON MCNAUGHT LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNAUGHT
Provider First Name:
JENNIFER
Provider Middle Name:
ANDERSON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SECOR
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
ANDERSON
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376731281
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
860 E 4500 S
Provider Second Line Business Mailing Address:
SUITE 302
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84107-3002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-706-9272
Provider Business Mailing Address Fax Number:
801-268-3777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
860 E 4500 S
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107-3002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-706-9272
Provider Business Practice Location Address Fax Number:
801-268-3777
Provider Enumeration Date:
10/05/2007

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:  361214-6004 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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