1528653870 NPI number — LINDA SCHARTMAN MA, LPC

Table of content: LINDA SCHARTMAN MA, LPC (NPI 1528653870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528653870 NPI number — LINDA SCHARTMAN MA, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHARTMAN
Provider First Name:
LINDA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LPC
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:
1528653870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1995 NEWMARK AVE # 1028
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COOS BAY
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97420-4727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-252-3588
Provider Business Mailing Address Fax Number:
541-314-9478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
281 LACLAIR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOS BAY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-252-3588
Provider Business Practice Location Address Fax Number:
541-314-9478
Provider Enumeration Date:
03/08/2021

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:  C7200 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: C7200 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1528653870 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500790431 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: C7200 . This is a "LICENSE NUMBER (LPC)" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 101YM0800X . This is a "TAXONOMY CODE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1528653870 . This is a "OHP RENDERING PHYSICIAN NUMBER" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 15813221 . This is a "CAQH PROVIDER ID" identifier . This identifiers is of the category "OTHER".




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