1528232717 NPI number — MS. CAROLYNN MARIE ALVORD MA, RN, LLP, LPC, CC

Table of content: SHERRY GORDAN (NPI 1629882931)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528232717 NPI number — MS. CAROLYNN MARIE ALVORD MA, RN, LLP, LPC, CC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALVORD
Provider First Name:
CAROLYNN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, RN, LLP, LPC, CC
Provider Gender Code:
F

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:
1528232717
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8155 N 40TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49012-9261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-731-5486
Provider Business Mailing Address Fax Number:
269-731-5486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8799 GULL RD
Provider Second Line Business Practice Location Address:
#6
Provider Business Practice Location Address City Name:
RICHLAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49083-9100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-207-7895
Provider Business Practice Location Address Fax Number:
269-731-5486
Provider Enumeration Date:
04/17/2008

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: 101Y00000X , with the licence number:  6401002275 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC1900X , with the licence number: 6301009110 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WC0400X , with the licence number: 4704117831 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 11833182 . This is a "CAQH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com