1972782498 NPI number — MRS. ERIN VERANNE DELMAR LCMFT

Table of content: MRS. ERIN VERANNE DELMAR LCMFT (NPI 1972782498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972782498 NPI number — MRS. ERIN VERANNE DELMAR LCMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELMAR
Provider First Name:
ERIN
Provider Middle Name:
VERANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCMFT
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:
1972782498
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7570 W 21ST ST N
Provider Second Line Business Mailing Address:
BUILDING 1050 SUITE E
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67205-1734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-990-8380
Provider Business Mailing Address Fax Number:
316-260-9342

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7570 W 21ST ST N
Provider Second Line Business Practice Location Address:
BUILDING 1050 SUITE E
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67205-1734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-990-8380
Provider Business Practice Location Address Fax Number:
316-260-9342
Provider Enumeration Date:
10/31/2007

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: 106H00000X , with the licence number:  820 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200527880B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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