1790298719 NPI number — NORTHAMPTON INSTITUTE OF INTERSUBJECTIVE PSYCHOTHERAPY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790298719 NPI number — NORTHAMPTON INSTITUTE OF INTERSUBJECTIVE PSYCHOTHERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHAMPTON INSTITUTE OF INTERSUBJECTIVE PSYCHOTHERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1790298719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 CENTER ST STE 428
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHAMPTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01060-3078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-341-1455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 CENTER ST STE 428
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-3078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-341-1455
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2017

Additional Information

Authorized Official

Authorized Official Last Name:
TEW
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
Authorized Official Title or Position:
CO-DIRECTOR
Authorized Official Telephone Number:
413-341-1455

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  119380 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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