1548317134 NPI number — TRANSITIONS COUNSELING SERVICES, LLC

Table of content: (NPI 1548317134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548317134 NPI number — TRANSITIONS COUNSELING SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSITIONS COUNSELING SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1548317134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1298
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE DALLES
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97058-9298
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-493-1467
Provider Business Mailing Address Fax Number:
509-493-3765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2101 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
BAKER CITY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97814-2621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-524-0800
Provider Business Practice Location Address Fax Number:
509-493-3765
Provider Enumeration Date:
01/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TATE
Authorized Official First Name:
CAROLANN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
509-493-1467

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  L2571 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 278888 . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: 808073000 . This is a "REGENCE BCBS" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".
  • Identifier: YA60301 . This is a "PACIFIC SOURCE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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