Georgianna Mack, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Red Springs, NC

NPI 1447570577 · NPPES record last updated Jun 11, 2010

Key facts

NPI
1447570577
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C006691 (NC)
Practice address
1244 Mount Tabor Rd
Red Springs, NC 28377-6324
Phone
(910) 843-7366
NPI assigned
Jun 11, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C006691NCMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C006691 NC Yes

Addresses

Primary practice location

1244 Mount Tabor Rd
Red Springs, NC 28377-6324

Mailing address

1244 Mount Tabor Rd
Red Springs, NC 28377-6324
Phone (910) 843-7366

Other providers in Red Springs, NC

All providers in Red Springs, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.