1598948572 NPI number — EMPLOYEE AND FAMILY COUNSLEING CENTER

Table of content: (NPI 1598948572)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598948572 NPI number — EMPLOYEE AND FAMILY COUNSLEING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPLOYEE AND FAMILY COUNSLEING CENTER
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:
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:
1598948572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2783
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVENPORT
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52809-2783
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-381-8088
Provider Business Mailing Address Fax Number:
563-823-8694

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
718 BRIDGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVENPORT
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52803-5620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-381-8088
Provider Business Practice Location Address Fax Number:
563-823-8694
Provider Enumeration Date:
12/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PHELPS
Authorized Official First Name:
HARRIET
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER/COUNSELOR
Authorized Official Telephone Number:
563-381-8088

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 238252 . This is a "MIDLAND'S CHOICE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 36005 . This is a "WELLMARK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 396294 . This is a "VALUE OPTIONS RAILROAD" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0457481 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 216358 . This is a "IOWA HEALTH" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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