Carol Jean Portner, LCSW

Individual provider Active NPI Clinical Social Worker · Biscoe, NC

NPI 1124372958 · NPPES record last updated Oct 31, 2012

Key facts

NPI
1124372958
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C008021 (NC)
Practice address
401 Lambert Rd
Biscoe, NC 27209-9002
Phone
(910) 428-2117
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Psych on Site of North Carolina, Inc Clinical Current
since Mar 26, 2013
Accepting new patients

Locations

3007 Caroline St
Houston, TX 77004
Phone (713) 528-2328

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C008021 NC Yes

Addresses

Primary practice location

401 Lambert Rd
Biscoe, NC 27209-9002

Mailing address

13575 58TH St N
Suite 190
Clearwater, FL 33760-3740

Other providers in Biscoe, NC

All providers in Biscoe, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.