1427341106 NPI number — MRS. BARBARA JEAN MITCHELL-VARNUM M.S., C.A.G.S. L.P.C

Table of content: MRS. BARBARA JEAN MITCHELL-VARNUM M.S., C.A.G.S. L.P.C (NPI 1427341106)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427341106 NPI number — MRS. BARBARA JEAN MITCHELL-VARNUM M.S., C.A.G.S. L.P.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MITCHELL-VARNUM
Provider First Name:
BARBARA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., C.A.G.S. L.P.C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VARNUM
Provider Other First Name:
BARBARA
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1427341106
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 HOADLY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMSTON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06231-1509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-228-8790
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 HOADLY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMSTON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06231-1509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-228-8790
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2011

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: 101YP2500X , with the licence number:  000476 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12244010 . This is a "CAQH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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