1386938876 NPI number — MISS AMY JOANN REMINGTON LPC

Table of content: MISS AMY JOANN REMINGTON LPC (NPI 1386938876)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386938876 NPI number — MISS AMY JOANN REMINGTON LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REMINGTON
Provider First Name:
AMY
Provider Middle Name:
JOANN
Provider Name Prefix Text:
MISS
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:
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:
1386938876
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1430 WILKINS CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CASPER
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82601-1336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-237-9583
Provider Business Mailing Address Fax Number:
307-265-7277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3860 WASHAKIE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CASPER
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82609-2337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-595-8143
Provider Business Practice Location Address Fax Number:
307-265-7277
Provider Enumeration Date:
06/02/2011

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: 101Y00000X , with the licence number:  LPC-1370 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 1370 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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