1942336037 NPI number — DRAWBRIGES COUNSELING SERVICES

Table of content: (NPI 1942336037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942336037 NPI number — DRAWBRIGES COUNSELING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRAWBRIGES COUNSELING SERVICES
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:
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:
1942336037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10304 SPOTSYLVANIA AVE
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
FREDERICKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22408-8602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-710-6085
Provider Business Mailing Address Fax Number:
540-710-6447

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7410 NEW LAGRANGE RD
Provider Second Line Business Practice Location Address:
STE 320
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40222-4871
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-225-9199
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DWYRE
Authorized Official First Name:
ELENA
Authorized Official Middle Name:
Authorized Official Title or Position:
STATE EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
502-225-9199

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 29200185 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com