1548748015 NPI number — SUSANNE ASCHER WALKER WILSON

Table of content: (NPI 1548748015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548748015 NPI number — SUSANNE ASCHER WALKER WILSON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUSANNE ASCHER WALKER WILSON
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:
1548748015
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
31 WOODVALE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28804-3508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-450-1052
Provider Business Mailing Address Fax Number:
888-365-0656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
156 E CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-2337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-450-1052
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WALKER WILSON
Authorized Official First Name:
SUSANNE
Authorized Official Middle Name:
ASCHER
Authorized Official Title or Position:
LCSW
Authorized Official Telephone Number:
828-450-1052

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C010126 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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