1396945432 NPI number — CLINICAL COUNSELING PRACTICE, PLLC

Table of content: DAVID P STEED DPM (NPI 1104857382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396945432 NPI number — CLINICAL COUNSELING PRACTICE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICAL COUNSELING PRACTICE, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1396945432
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
123 PLEASANT VIEW LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EZEL
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41425-8522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-495-5478
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST LIBERTY
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41472-1015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-495-5478
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROSS
Authorized Official First Name:
JIMALEE
Authorized Official Middle Name:
Y
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
606-495-5478

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  3019 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1376698167 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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