1700141694 NPI number — MARY KATHERINE MCCLINTON-SAUNDERS LPC

Table of content: MARY KATHERINE MCCLINTON-SAUNDERS LPC (NPI 1700141694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700141694 NPI number — MARY KATHERINE MCCLINTON-SAUNDERS LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCLINTON-SAUNDERS
Provider First Name:
MARY
Provider Middle Name:
KATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
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:
1700141694
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 UNIVERSITY CITY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLACKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24060-2706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-961-8459
Provider Business Mailing Address Fax Number:
540-443-0053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7193 WARDEN CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRLAWN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24141-8445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-961-8300
Provider Business Practice Location Address Fax Number:
540-443-0053
Provider Enumeration Date:
07/07/2012

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: 101YP2500X , with the licence number:  0701005227 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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