1679640452 NPI number — SUSAN F STANHOPE LICSW

Table of content: SUSAN F STANHOPE LICSW (NPI 1679640452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679640452 NPI number — SUSAN F STANHOPE LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STANHOPE
Provider First Name:
SUSAN
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW
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:
1679640452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18 STARLIGHT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAKEFIELD
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02879-7808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-742-1765
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
212 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAKEFIELD
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-742-1765
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2006

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: 1041C0700X , with the licence number:  ISW01161 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 140001161RI01 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 140001161RI02 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22351-9 . This is a "BLUE CROSS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 308018 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 359528500 . This is a "OFFICE OF WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 407818 . This is a "BLUE CHIP COORDINATED HEA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 62-48888 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: IP308353 . This is a "MAGELLAN HEALTH SERVICES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020660 . This is a "BECON HEALTH STRATEGIES" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com