1558373951 NPI number — HENNING & COLE THERAPY ASSOCIATES, LTD.

Table of content: (NPI 1558373951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558373951 NPI number — HENNING & COLE THERAPY ASSOCIATES, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENNING & COLE THERAPY ASSOCIATES, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1558373951
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 WARREN RD
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
COCKEYSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21030-2506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-683-9900
Provider Business Mailing Address Fax Number:
410-683-3355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 BATA BLVD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
BELCAMP
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21017-1431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-273-6000
Provider Business Practice Location Address Fax Number:
410-273-6061
Provider Enumeration Date:
08/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HENNING
Authorized Official First Name:
RODGER
Authorized Official Middle Name:
C
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
410-683-9900

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: H-187 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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