1992080204 NPI number — MRS. SALLY KATHARINE WHITE MARKLEY LPC

Table of content: MRS. SALLY KATHARINE WHITE MARKLEY LPC (NPI 1992080204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992080204 NPI number — MRS. SALLY KATHARINE WHITE MARKLEY LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE MARKLEY
Provider First Name:
SALLY
Provider Middle Name:
KATHARINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARKLEY
Provider Other First Name:
SALLY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC, ATR
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1992080204
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4848 E PLACITA ABREVADERO
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85712-1253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-903-8877
Provider Business Mailing Address Fax Number:
520-979-3562

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4806 E CAMP LOWELL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85712-1276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-903-8877
Provider Business Practice Location Address Fax Number:
520-979-3562
Provider Enumeration Date:
10/18/2011

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: 101YM0800X , with the licence number:  LPC-10316 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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