1780082370 NPI number — LORIE ANN MOBLEY AMMON LPC

Table of content: LORIE ANN MOBLEY AMMON LPC (NPI 1780082370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780082370 NPI number — LORIE ANN MOBLEY AMMON LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMMON
Provider First Name:
LORIE
Provider Middle Name:
ANN MOBLEY
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:
1780082370
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7557 RAMBLER RD STE 730
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-2405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-638-0905
Provider Business Mailing Address Fax Number:
214-696-2977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7557 RAMBLER RD STE 730
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-2405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-638-0905
Provider Business Practice Location Address Fax Number:
214-696-2977
Provider Enumeration Date:
12/12/2014

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:  69984 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 69984 . This is a "LICENSED PROFESSIONAL COUNSELOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com