1700136918 NPI number — MRS. MARIA SMITH CCTS,CGLC

Table of content: MRS. MARIA SMITH CCTS,CGLC (NPI 1700136918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700136918 NPI number — MRS. MARIA SMITH CCTS,CGLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
MARIA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CCTS,CGLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROVERS
Provider Other First Name:
MARIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CGLC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700136918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
461 COCHRAN RD
Provider Second Line Business Mailing Address:
#140
Provider Business Mailing Address City Name:
MT LEBANON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15228-1253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-969-2733
Provider Business Mailing Address Fax Number:
412-774-2069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 BOWER HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15228-1419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-969-2733
Provider Business Practice Location Address Fax Number:
412-774-2069
Provider Enumeration Date:
09/14/2012

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: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 172V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2400X , with the licence number: PA-2279 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2500X , with the licence number: PA-2279 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 246Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225CA2400X , with the licence number: PA-2279 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2400X , with the licence number: PA-2279 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2400X , with the licence number: PA-2279 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2500X , with the licence number: PA-2279 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2500X , with the licence number: PA-2279 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2500X , with the licence number: PA-2279 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225CA2500X , with the licence number: PA-2279 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: PA-2279(A) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: PA-2279(A) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA-2279(A) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1082811775 . This is a "GLC CERTIFICATION BY SPENCER INSTITUTE(GREEN LIVING)" identifier . This identifiers is of the category "OTHER".
  • Identifier: PA-2279(A) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: PA-2279(A) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".