Yvonne Johnson-Gilbert, LCSW,DCSW,ATODS,CCJS

Individual provider Active NPI Specialist · Canton, NC

NPI 1528097334 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1528097334
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
Practice address
20 Cowboy Way
Canton, NC 28716-9411
Phone
(282) 648-8052
Fax
(828) 648-8052
NPI assigned
Jul 2, 2006
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)
Yes

State licenses

LicenseStateTypeSpecialty
881871467NCMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NC Yes

Addresses

Primary practice location

20 Cowboy Way
Canton, NC 28716-9411

Mailing address

PO Box 30
Canton, NC 28716-0030
Phone (828) 648-8052

Other identifiers

IdentifierTypeStateIssuer
88187467OtherNCLCSW,DCSW, ATODS,CCJS.
6002305MedicaidNC

Other providers in Canton, NC

All providers in Canton, NC · Specialist in North Carolina

Sources for this page

Verify at the official NPI Registry.