1831561422 NPI number — ARICA DAWE

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 1831561422 NPI number — ARICA DAWE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARICA DAWE
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:
HEART TO HEART COUNSELING
Provider Other Organization Name Type Code:
3
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:
1831561422
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2433 PROGRESSIVE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEWARD
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68434-7644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-641-8393
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2433 PROGRESSIVE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEWARD
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68434-7644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-641-8393
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/22/2015

Additional Information

Authorized Official

Authorized Official Last Name:
DAWE
Authorized Official First Name:
ARICA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
402-641-8393

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  4628 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1002630902 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100263509-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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