1962748392 NPI number — CHRISTINE HORNE LMHC

Table of content: CHRISTINE HORNE LMHC (NPI 1962748392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962748392 NPI number — CHRISTINE HORNE LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORNE
Provider First Name:
CHRISTINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
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:
1962748392
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4460 S HIGHLAND DR STE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84124-3550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-949-4864
Provider Business Mailing Address Fax Number:
904-448-4717

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 S 2220 W APT 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLEASANT GROVE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84062-3183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-525-2890
Provider Business Practice Location Address Fax Number:
904-448-4717
Provider Enumeration Date:
12/12/2012

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: 101YM0800X , with the licence number:  MH15100 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 11631941-6004 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: MH15100 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 11631941-6004 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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