1689742843 NPI number — MS. H. ELAINA DENNEY LCMHC

Table of content: MS. H. ELAINA DENNEY LCMHC (NPI 1689742843)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689742843 NPI number — MS. H. ELAINA DENNEY LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DENNEY
Provider First Name:
H. ELAINA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCMHC
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:
1689742843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
72 COTTON MILL HL
Provider Second Line Business Mailing Address:
SUITE 226 A
Provider Business Mailing Address City Name:
BRATTLEBORO
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05301-7170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-579-2303
Provider Business Mailing Address Fax Number:
802-257-0294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
72 COTTON MILL HL
Provider Second Line Business Practice Location Address:
SUITE 226 A
Provider Business Practice Location Address City Name:
BRATTLEBORO
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05301-7170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-579-2303
Provider Business Practice Location Address Fax Number:
802-257-0294
Provider Enumeration Date:
12/04/2006

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: 101YM0800X , with the licence number:  0680062095 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1020486 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12341487 . This is a "CAQH" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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