1437413523 NPI number — KAREN SUZANNE NORTHCOTT MSW, LCSW

Table of content: KAREN SUZANNE NORTHCOTT MSW, LCSW (NPI 1437413523)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437413523 NPI number — KAREN SUZANNE NORTHCOTT MSW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORTHCOTT
Provider First Name:
KAREN
Provider Middle Name:
SUZANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW
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:
1437413523
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
745 CRAIG RD
Provider Second Line Business Mailing Address:
SUITE 212
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63141-7160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-395-7560
Provider Business Mailing Address Fax Number:
314-395-7563

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
745 CRAIG RD
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63141-7160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-395-7560
Provider Business Practice Location Address Fax Number:
314-395-7563
Provider Enumeration Date:
07/03/2012

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: 104100000X , with the licence number:  000551 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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