1912296518 NPI number — DR. CYNTHIA R RASSIGA-WEST M.DIV, LPC, D.MIN

Table of content: DR. CYNTHIA R RASSIGA-WEST M.DIV, LPC, D.MIN (NPI 1912296518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912296518 NPI number — DR. CYNTHIA R RASSIGA-WEST M.DIV, LPC, D.MIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RASSIGA-WEST
Provider First Name:
CYNTHIA
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.DIV, LPC, D.MIN
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:
1912296518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
W157 N8327 PILGRIM RD
Provider Second Line Business Mailing Address:
308
Provider Business Mailing Address City Name:
MENOMONEE FALLS
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53051-5748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-251-1112
Provider Business Mailing Address Fax Number:
262-251-1113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
W157 N8327 PILGRIM RD
Provider Second Line Business Practice Location Address:
308
Provider Business Practice Location Address City Name:
MENOMONEE FALLS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-251-1112
Provider Business Practice Location Address Fax Number:
262-251-1113
Provider Enumeration Date:
04/04/2011

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: 101YP2500X , with the licence number:  180006354 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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