1851314678 NPI number — DR. TERESA MCCRAY HARMON PH.D.

Table of content: RALPHINE L PROFITT (NPI 1750789152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851314678 NPI number — DR. TERESA MCCRAY HARMON PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARMON
Provider First Name:
TERESA
Provider Middle Name:
MCCRAY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1851314678
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29 STONERIDGE DR
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
WAYNESBORO
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22980-6598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-942-5155
Provider Business Mailing Address Fax Number:
540-941-8181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 STONERIDGE DR
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
WAYNESBORO
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22980-6598
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-942-5155
Provider Business Practice Location Address Fax Number:
540-941-8181
Provider Enumeration Date:
07/25/2006

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: 103TC0700X , with the licence number:  0810001297 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 007702515 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 085469 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 085469 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 052064 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 162626000 . This is a "MAGELLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 152626 . This is a "VALUE OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4345742 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 085469 . This is a "OPTIMA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1021603 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 132941 . This is a "MHN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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