1700354651 NPI number — MR. KENNETH ERIC LENHARDT MSW

Table of content: MR. KENNETH ERIC LENHARDT MSW (NPI 1700354651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700354651 NPI number — MR. KENNETH ERIC LENHARDT MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LENHARDT
Provider First Name:
KENNETH
Provider Middle Name:
ERIC
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW
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:
1700354651
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HIGASHI KUSABUKA CHO 4-8, 2ND FLOOR
Provider Second Line Business Mailing Address:
AOI KU
Provider Business Mailing Address City Name:
SHIZUOKA CITY
Provider Business Mailing Address State Name:
SHIZUOKA KEN
Provider Business Mailing Address Postal Code:
4200865
Provider Business Mailing Address Country Code:
JP
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HIGASHI KUSABUKA CHO 4-8, 2ND FLOOR
Provider Second Line Business Practice Location Address:
AOI KU
Provider Business Practice Location Address City Name:
SHIZUOKA CITY
Provider Business Practice Location Address State Name:
SHIZUOKA KEN
Provider Business Practice Location Address Postal Code:
4200865
Provider Business Practice Location Address Country Code:
JP
Provider Business Practice Location Address Telephone Number:
54-340-0700
Provider Business Practice Location Address Fax Number:
54-340-0700
Provider Enumeration Date:
11/08/2018

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:  CW018713 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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