1831156702 NPI number — ANA ROSA DELGADO LPC CAS

Table of content: ANA ROSA DELGADO LPC CAS (NPI 1831156702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831156702 NPI number — ANA ROSA DELGADO LPC CAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELGADO
Provider First Name:
ANA
Provider Middle Name:
ROSA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC CAS
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:
1831156702
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
58TH ST AND SUPPORT AVE
Provider Second Line Business Mailing Address:
BLDG 2242 FT HOOD
Provider Business Mailing Address City Name:
KILLEEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76544-4752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-287-5272
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
58TH ST AND SUPPORT AVE
Provider Second Line Business Practice Location Address:
BLDG 2242
Provider Business Practice Location Address City Name:
KILLEEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544-4752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-287-5272
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2006

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: 101YP2500X , with the licence number:  19362 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: C4487 . This is a "SUBSTANCE ABUSE CERTIFICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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