1992881312 NPI number — MRS. SYLVIA S ROAN L.C.S.W., LISW-CP,

Table of content: MRS. SYLVIA S ROAN L.C.S.W., LISW-CP, (NPI 1992881312)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992881312 NPI number — MRS. SYLVIA S ROAN L.C.S.W., LISW-CP,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROAN
Provider First Name:
SYLVIA
Provider Middle Name:
S
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W., LISW-CP,
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHU
Provider Other First Name:
SIU-FENG
Provider Other Middle Name:
SYLVIA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992881312
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1362 SECRET PATH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MILL
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29708-6545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-236-9390
Provider Business Mailing Address Fax Number:
803-693-0701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2012 HIGHWAY 160 W
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
FORT MILL
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29708-8401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-236-9390
Provider Business Practice Location Address Fax Number:
803-693-0701
Provider Enumeration Date:
10/27/2006

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: 1041C0700X , with the licence number:  SW5237 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 9585 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: C006890 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com