1487760005 NPI number — DONNA ZIMMERMAN BARASCH MA LPCC

Table of content: JEANNINE MAKANGA THALO (NPI 1073326864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487760005 NPI number — DONNA ZIMMERMAN BARASCH MA LPCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARASCH
Provider First Name:
DONNA
Provider Middle Name:
ZIMMERMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA LPCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZIMMERMAN
Provider Other First Name:
DONNA
Provider Other Middle Name:
SUE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA LPCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487760005
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9900 CINCINNATI COLUMBUS ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45241-1209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-779-9955
Provider Business Mailing Address Fax Number:
513-779-9955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9900 CINCINNATI COLUMBUS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45241-1209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-779-9955
Provider Business Practice Location Address Fax Number:
513-779-9955
Provider Enumeration Date:
08/23/2006

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: 103T00000X , with the licence number:  E0000852 , 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: 000000222122 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 024750 . This is a "VMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1218030 . This is a "CHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 505826 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 307555 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 026935000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".




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