1952332413 NPI number — MRS. SARAH SHUMPERT TOTUSHEK LCPC

Table of content: MRS. SARAH SHUMPERT TOTUSHEK LCPC (NPI 1952332413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952332413 NPI number — MRS. SARAH SHUMPERT TOTUSHEK LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOTUSHEK
Provider First Name:
SARAH
Provider Middle Name:
SHUMPERT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCPC
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:
1952332413
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5407 N CHARLES ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21210-2024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-433-8861
Provider Business Mailing Address Fax Number:
410-433-1249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5407 N CHARLES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21210-2024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-433-8861
Provider Business Practice Location Address Fax Number:
410-433-1249
Provider Enumeration Date:
07/05/2006

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: 101Y00000X , with the licence number:  LC 0851 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 226234 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 330045 . This is a "MANAGED HEALTH NETWORK TR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 111065 . This is a "JOHNS HOPKINS HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0010 . This is a "FED BC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 605149 01 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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