1760492474 NPI number — MARGARET ALLYSON KING-CAGLE LCSW

Table of content: MARGARET ALLYSON KING-CAGLE LCSW (NPI 1760492474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760492474 NPI number — MARGARET ALLYSON KING-CAGLE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KING-CAGLE
Provider First Name:
MARGARET
Provider Middle Name:
ALLYSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAGLE
Provider Other First Name:
MARGARET
Provider Other Middle Name:
ALLYSON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1760492474
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8512 E PARKWAY S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAUDERDALE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39335-9567
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-632-1246
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
248 E CAPITOL ST
Provider Second Line Business Practice Location Address:
840 TRUST MARK BLDG
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39201-2503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-632-6074
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2006

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:  C1356 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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