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1518728245 NPI number — KINGSLEY CHIGBU PH.D. L.I.C.S.W

NPI Number: 1518728245
Health Care Provider/Practitioner: KINGSLEY CHIGBU PH.D. L.I.C.S.W

Information about “1518728245” NPI (KINGSLEY CHIGBU PH.D. L.I.C.S.W) exists in 1518728245 in HTML format HTML  |  1518728245 in plain Text format TXT  |  1518728245 in PDF (Portable Document Format) PDF  |  1518728245 in an XML format XML  formats.

NPI Number : 1518728245 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1518728245",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHIGBU",
    "FirstName": "KINGSLEY",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D. L.I.C.S.W",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12423 66TH PL N",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MAPLE GROVE",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55369-6060",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "612-940-9363",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2115 SUMMIT AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT PAUL",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55105-1048",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "612-940-9363",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/19/2024",
    "LastUpdateDate": "01/19/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "19712",
        "LicenseNumberStateCode": "MN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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