1922279033 NPI number — N E PSYCHOLOGICAL CONSULTANTS, INC.

Table of content: (NPI 1922279033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922279033 NPI number — N E PSYCHOLOGICAL CONSULTANTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
N E PSYCHOLOGICAL CONSULTANTS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1922279033
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45 MERRIMACK ST
Provider Second Line Business Mailing Address:
STE. 502
Provider Business Mailing Address City Name:
LOWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01852-1729
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-452-7038
Provider Business Mailing Address Fax Number:
978-452-7008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 MERRIMACK ST
Provider Second Line Business Practice Location Address:
STE. 502
Provider Business Practice Location Address City Name:
LOWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01852-1729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-452-7038
Provider Business Practice Location Address Fax Number:
978-452-7008
Provider Enumeration Date:
03/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GUZMAN
Authorized Official First Name:
NITA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRES. OF NEW ENGLAND PSYC. CON.
Authorized Official Telephone Number:
978-452-7038

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TB0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC1900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC2200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 9710370 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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