1902924798 NPI number — MR. NICHOLAS JOHN ROHALL LCSW

Table of content: ELISE MARIE MARTINEZ (NPI 1881726800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902924798 NPI number — MR. NICHOLAS JOHN ROHALL LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROHALL
Provider First Name:
NICHOLAS
Provider Middle Name:
JOHN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
M

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:
1902924798
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2703 W STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16101-8671
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-657-3303
Provider Business Mailing Address Fax Number:
724-657-3326

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2703 W STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-8645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-657-3033
Provider Business Practice Location Address Fax Number:
724-657-3326
Provider Enumeration Date:
03/27/2007

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: 104100000X , with the licence number:  CW015341 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: CW015341 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CW015341 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7387365 . This is a "AETNA BEHAVIORAL HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2284499 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: R0269342 . This is a "HIGHMARK MID-LEVEL FEP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 12765440 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 454362 . This is a "VALUE OPTIONS EAP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000269342 . This is a "KEYSTONE HEALTH PLAN WEST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1034569900001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 251830792 . This is a "CORP HEALTH/HUMANA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251830792 . This is a "INTERGROUP SERVICES CORPORATION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000203334 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 229266000 . This is a "MAGEALLAN BEHAVIORAL HEAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1830792 . This is a "MH NET" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2701966 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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