Free Will Baptist Childrens Home, Inc.
Organization Active NPI Clinical Social Worker · Middlesex, NC
NPI 1669529178 · NPPES record last updated Feb 12, 2013
Key facts
- NPI
- 1669529178
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- B00358 (NC)
- Legal business name
- FREE WILL BAPTIST CHILDRENS HOME, INC.
- Practice address
- 7907 Buck Deans Road
Middlesex, NC 27557 - Phone
- (252) 235-2161
- Fax
- (252) 235-2625
- NPI assigned
- Jan 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Gary W Lee
- Title
- President/Ceo
- Phone
- (252) 235-2161
Practitioners 2
-
Cyndi S Broadwater, LCSW
-
Anita Burleson Jarrard, MSW, LCSW
National Provider Directory
Locations
7907 Buck Deans Rd
Middlesex, NC 27557
Phone (252) 235-2161
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | B00358 | NC | Yes |
Addresses
Primary practice location
7907 Buck Deans Road
Middlesex, NC 27557
Mailing address
PO Box 249
Middlesex, NC 27557-0249
Phone (252) 235-2161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6005069 | Medicaid | NC |
Other providers in Middlesex, NC
- Tyler David Crofts
- Asantewaa Boateng Crumpler
- Zaki Krishan Faraz Dard
- DO Therapy 198, PLLC
- Crystal Crew Finnegan
- Mariel Marie Gampe
- Maria Manuela Garcia Hawley
- Roger Heeren
- Homes2Any LLC
- KMG Holdings, Inc
All providers in Middlesex, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.