1679997225 NPI number — MR. KEVIN CHADBOURNE DOWNS LPCI, CACP

Table of content: MELISSA ELLIS PMHNP (NPI 1053878611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679997225 NPI number — MR. KEVIN CHADBOURNE DOWNS LPCI, CACP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOWNS
Provider First Name:
KEVIN
Provider Middle Name:
CHADBOURNE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LPCI, CACP
Provider Gender Code:
M

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:
1679997225
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 E BAY ST
Provider Second Line Business Mailing Address:
SUITE 201-D
Provider Business Mailing Address City Name:
CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29401-2633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-469-5489
Provider Business Mailing Address Fax Number:
843-723-8002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 E BAY ST
Provider Second Line Business Practice Location Address:
SUITE 201-D
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29401-2633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-469-5489
Provider Business Practice Location Address Fax Number:
843-723-8002
Provider Enumeration Date:
02/18/2014

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: 101YP2500X , with the licence number:  5517 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com