1720118532 NPI number — MR. DONALD WALTER MCLAUGHLIN MA, MS, LLPC

Table of content: AMA FOSUA TWINTOH LPN (NPI 1912268491)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720118532 NPI number — MR. DONALD WALTER MCLAUGHLIN MA, MS, LLPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLAUGHLIN
Provider First Name:
DONALD
Provider Middle Name:
WALTER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MA, MS, LLPC
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:
1720118532
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8329 WAXWING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREELAND
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48623-8684
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-751-4200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3400 S WASHINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48601-4958
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
897-551-0729
Provider Business Practice Location Address Fax Number:
989-755-1401
Provider Enumeration Date:
03/07/2007

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: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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