1972588267 NPI number — MS. HEDY BEXTINE LISW LMFT MSW

Table of content: MS. HEDY BEXTINE LISW LMFT MSW (NPI 1972588267)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972588267 NPI number — MS. HEDY BEXTINE LISW LMFT MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEXTINE
Provider First Name:
HEDY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LISW LMFT MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BEXTINE
Provider Other First Name:
HEDY
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LISW LMFT MSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1972588267
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:
118 2ND ST SE
Provider Second Line Business Mailing Address:
STE 220
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52401-1210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-362-0632
Provider Business Mailing Address Fax Number:
319-362-5206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
118 2ND ST SE
Provider Second Line Business Practice Location Address:
STE 220
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52401-1210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-362-0632
Provider Business Practice Location Address Fax Number:
319-362-5206
Provider Enumeration Date:
12/09/2005

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: 104100000X , with the licence number:  2104 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 00133 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 20032571487726 . This is a "PRINCIPAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36074 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6226210 . This is a "UBH" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 2070318 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2157352 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 224832 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36074 . This is a "WELLMARK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 7579033 . This is a "HAI EAP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7579033 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com