1427022961 NPI number — WILLIAM R HARGETT LPCC-S

Table of content: WILLIAM R HARGETT LPCC-S (NPI 1427022961)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427022961 NPI number — WILLIAM R HARGETT LPCC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARGETT
Provider First Name:
WILLIAM
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPCC-S
Provider Gender Code:
M

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:
1427022961
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
711 N COLUMBUS ST
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43130-2538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-653-6500
Provider Business Mailing Address Fax Number:
740-653-6501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
711 N COLUMBUS ST
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43130-2538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-653-6500
Provider Business Practice Location Address Fax Number:
740-653-6501
Provider Enumeration Date:
02/13/2006

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: 101YM0800X , with the licence number:  E 0001639 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: E 0001639 . This is a "LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000387056 . This is a "ANTHEM BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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