1982861241 NPI number — MRS. BARBARA JAYNE FROEHLICH-STAPLETON LPC LMSW

Table of content: MRS. BARBARA JAYNE FROEHLICH-STAPLETON LPC LMSW (NPI 1982861241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982861241 NPI number — MRS. BARBARA JAYNE FROEHLICH-STAPLETON LPC LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FROEHLICH-STAPLETON
Provider First Name:
BARBARA
Provider Middle Name:
JAYNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC LMSW
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:
1982861241
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 354
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLEN PARK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48101-0354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-381-0748
Provider Business Mailing Address Fax Number:
734-427-8594

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31530 BEECHWOOD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-381-0748
Provider Business Practice Location Address Fax Number:
734-427-8594
Provider Enumeration Date:
05/22/2008

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: 101YP2500X , with the licence number:  6401002474 , 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: 5801065455 , 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: P20896488 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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