1881758548 NPI number — MS. DOREEN GEORGINA LEO-HUNEKE L.C.S.W.

Table of content: MS. DOREEN GEORGINA LEO-HUNEKE L.C.S.W. (NPI 1881758548)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881758548 NPI number — MS. DOREEN GEORGINA LEO-HUNEKE L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEO-HUNEKE
Provider First Name:
DOREEN
Provider Middle Name:
GEORGINA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
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:
1881758548
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1110 HIDE AWAY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KODAK
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37764-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-850-9745
Provider Business Mailing Address Fax Number:
865-933-6015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1110 HIDE AWAY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KODAK
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37764-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-850-9745
Provider Business Practice Location Address Fax Number:
865-933-6015
Provider Enumeration Date:
12/20/2006

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: 1041C0700X , with the licence number:  4726 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: R052355-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1515256 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 336850 . This is a "VALUE OPTIONS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: P2564831 . This is a "OXFORD INS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 188196644 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 275886000 . This is a "MAGELLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7480617 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4228156 . This is a "MAGELLAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1881758548 . This is a "CIGNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: NY052355 . This is a "1199 SEIU N.B.F." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1515256 . This is a "AMERICA CHOICE (MEDICAID)" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1881758548 . This is a "TRICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7495229 . This is a "AETNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 336850 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 41363P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com