1912493206 NPI number — EMILY MARGARET LITTON CSW

Table of content: EMILY MARGARET LITTON CSW (NPI 1912493206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912493206 NPI number — EMILY MARGARET LITTON CSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LITTON
Provider First Name:
EMILY
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CSW
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:
1912493206
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10100 ELIDA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELPHOS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45833-9058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-695-8010
Provider Business Mailing Address Fax Number:
606-328-5153

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2734 CHANCELLOR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRESTVIEW HILLS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41017-3487
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
593-419-3338
Provider Business Practice Location Address Fax Number:
859-341-9444
Provider Enumeration Date:
07/10/2018

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 258395 . This is a "CSW" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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