Charles Wesley Mauney

Individual provider Active NPI Clinical Social Worker · Maxton, NC

NPI 1972188159 · NPPES record last updated Mar 10, 2021

Key facts

NPI
1972188159
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
P015806 (NC)
Practice address
109 W Central St
Maxton, NC 28364-1703
Phone
(910) 844-2267
Fax
(910) 401-1083
NPI assigned
Mar 10, 2021
Sex
Male
Sole proprietor
No

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)
No

State licenses

LicenseStateTypeSpecialty
P015806NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Behavioral Healthcare Services Clinical Past
since Sep 22, 2012
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P015806 NC Yes

Addresses

Primary practice location

109 W Central St
Maxton, NC 28364-1703

Mailing address

PO Box 1004
Lumberton, NC 28359-1004
Phone (910) 844-2267

Other practice location 1

3581 Lackey St
Lumberton, NC 28360-9048
Phone (191) 073-8502 ext. 123

Other practice location 2

310 Harris Ave
Raeford, NC 28376-3110
Phone (910) 733-3482 ext. 123

Other identifiers

IdentifierTypeStateIssuer
1932304714MedicaidNC

Electronic endpoints

TypeEndpointUseAffiliation
Other URL cARE360

Other providers in Maxton, NC

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

Sources for this page

Verify at the official NPI Registry.