1972678464 NPI number — THE PSYCHOTHERAPY CENTER SOLUTIONS FOR LIVING LTD

Table of content: (NPI 1972678464)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972678464 NPI number — THE PSYCHOTHERAPY CENTER SOLUTIONS FOR LIVING LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE PSYCHOTHERAPY CENTER SOLUTIONS FOR LIVING LTD
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:
6
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:
1972678464
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
327 W 21ST ST
Provider Second Line Business Mailing Address:
205
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23517-2130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-622-9852
Provider Business Mailing Address Fax Number:
757-622-4033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
327 W 21ST ST
Provider Second Line Business Practice Location Address:
205
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23517-2130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-622-9852
Provider Business Practice Location Address Fax Number:
757-622-4033
Provider Enumeration Date:
11/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RABINOWITZ
Authorized Official First Name:
MARC
Authorized Official Middle Name:
D
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
757-622-9852

Provider Taxonomy Codes

  • Taxonomy code: 103TP2701X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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