Provider Demographics
NPI:1235327735
Name:CONTRACTOR, ATEKA A (SW)
Entity Type:Individual
Prefix:
First Name:ATEKA
Middle Name:A
Last Name:CONTRACTOR
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 LINCOLNWAY
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-5727
Mailing Address - Country:US
Mailing Address - Phone:219-548-8727
Mailing Address - Fax:219-465-7211
Practice Address - Street 1:607 LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-5727
Practice Address - Country:US
Practice Address - Phone:219-548-8727
Practice Address - Fax:219-465-7211
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200880TMedicare PIN