1144351438 NPI number — MS. KERI MAE LANPHEAR M.S., LPC, SAC-IT

Table of content: MS. KERI MAE LANPHEAR M.S., LPC, SAC-IT (NPI 1144351438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144351438 NPI number — MS. KERI MAE LANPHEAR M.S., LPC, SAC-IT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANPHEAR
Provider First Name:
KERI
Provider Middle Name:
MAE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., LPC, SAC-IT
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:
1144351438
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1040 RIVERBEND DR
Provider Second Line Business Mailing Address:
APT. 6
Provider Business Mailing Address City Name:
HARTFORD
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53027-9473
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-670-6324
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9330 W LINCOLN AVE
Provider Second Line Business Practice Location Address:
SUITE 21
Provider Business Practice Location Address City Name:
WEST ALLIS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53227-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-546-6880
Provider Business Practice Location Address Fax Number:
414-546-6234
Provider Enumeration Date:
03/08/2007

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: 101YA0400X , with the licence number:  14825 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YM0800X , with the licence number: 3871-125 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





Copyright © 2007-2025 www.npivalidator.com