1609170612 NPI number — NOREEN S CONLON LMHC LLC

Table of content: (NPI 1609170612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609170612 NPI number — NOREEN S CONLON LMHC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOREEN S CONLON LMHC 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:
1609170612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 412
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01473-0412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-827-5389
Provider Business Mailing Address Fax Number:
978-874-2112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 2B
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01473-1472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-827-5389
Provider Business Practice Location Address Fax Number:
978-874-2112
Provider Enumeration Date:
01/05/2011

Additional Information

Authorized Official

Authorized Official Last Name:
CONLON
Authorized Official First Name:
NOREEN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
978-827-5389

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  5587 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 282714 . This is a "MHN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 018377 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1037830 . This is a "BEACON HEALTH STRATEGIES/FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1895389 . This is a "MBHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110032466A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 495371 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 96723801 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: LM1169 . This is a "BLUE CROSS BLUE SHIELD OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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