1932256971 NPI number — MS. MICHELE MCKINLEY HARRINGTON LCSW

Table of content: MS. MICHELE MCKINLEY HARRINGTON LCSW (NPI 1932256971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932256971 NPI number — MS. MICHELE MCKINLEY HARRINGTON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRINGTON
Provider First Name:
MICHELE
Provider Middle Name:
MCKINLEY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
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:
1932256971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8114 WINDOVER WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TITUSVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32780-2514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-267-6488
Provider Business Mailing Address Fax Number:
321-264-9659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5095 S. WAHINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
TITUSVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-264-2808
Provider Business Practice Location Address Fax Number:
321-264-9659
Provider Enumeration Date:
01/04/2007

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: 1041C0700X , with the licence number:  SW-5102 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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