1477936698 NPI number — DOROTHY JEAN EARLEY LMHC

Table of content: DOROTHY JEAN EARLEY LMHC (NPI 1477936698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477936698 NPI number — DOROTHY JEAN EARLEY LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EARLEY
Provider First Name:
DOROTHY
Provider Middle Name:
JEAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUSZYNSKI
Provider Other First Name:
DOROTHY
Provider Other Middle Name:
JEAN
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:
1477936698
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
223 BARNARD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRANVILLE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01034-9527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-573-4406
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 ATWOOD DR
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-4272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-773-1314
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2015

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: 101YS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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