1982260170 NPI number — LAMINIT COUNSELING SERVICES LLC

Table of content: MR. DONNIE LEE STRAIGHT III LMT (NPI 1730698606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982260170 NPI number — LAMINIT COUNSELING SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAMINIT COUNSELING SERVICES 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:
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:
1982260170
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 SENATE BROOK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMSTON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06231-1521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-508-4286
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
313 NEW LONDON TPKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLASTONBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06033-2233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-508-4286
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2019

Additional Information

Authorized Official

Authorized Official Last Name:
LAMB
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
860-508-4286

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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