1447524152 NPI number — KARLI CATHLEEN MEAGHER LCSW

Table of content: KARLI CATHLEEN MEAGHER LCSW (NPI 1447524152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447524152 NPI number — KARLI CATHLEEN MEAGHER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEAGHER
Provider First Name:
KARLI
Provider Middle Name:
CATHLEEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MINICLIER
Provider Other First Name:
KARLI
Provider Other Middle Name:
CATHLEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447524152
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 CALHOUN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-238-1301
Provider Business Mailing Address Fax Number:
276-238-1302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 CALHOUN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-238-1301
Provider Business Practice Location Address Fax Number:
276-238-1302
Provider Enumeration Date:
02/27/2012

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: 1041C0700X , with the licence number:  0904008546 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0903001796 . This is a "BOARD OF SOCIAL WORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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