1972773182 NPI number — INTERPRETIVE ARTS COUNSELING LLC

Table of content: (NPI 1972773182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972773182 NPI number — INTERPRETIVE ARTS COUNSELING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTERPRETIVE ARTS COUNSELING LLC
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:
SHARON CIPRIANO GIALBREATH MA
Provider Other Organization Name Type Code:
5
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:
1972773182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
148 NORTH RIVERVIEW DRIVE
Provider Second Line Business Mailing Address:
PO BOX 188
Provider Business Mailing Address City Name:
PARCHMENT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-382-5343
Provider Business Mailing Address Fax Number:
269-226-0748

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
148 NORTH RIVERVIEW DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARCHMENT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-382-5343
Provider Business Practice Location Address Fax Number:
269-226-0748
Provider Enumeration Date:
03/04/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GIALBREATH
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
CIPRIANO
Authorized Official Title or Position:
PSYCHOLOGIST PROFESSIONAL COUNSELOR
Authorized Official Telephone Number:
269-382-5343

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  6401009506 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 6301009159 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: 6801063816 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 164W00000X , with the licence number: 4703015679 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 9899390 . This is a "DHS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 7484 . This is a "KCMH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".