Mr Keith G Pemberton I, MSW, P-LCSW is a
Social Worker - Clinical based in Greensboro, North Carolina. Mr Keith G Pemberton I is licensed to practice in North Carolina (license number P003878) and his current practice location is
801 Summit Ave, Suite 4, Greensboro, North Carolina. He can be reached at his office (for appointments etc.) via phone at
(336) 674-9781.
NPI number for Mr Keith G Pemberton I is 1073746772 and his current mailing address is 1589 Skeet Club Rd, Suite 102-251, High Point, North Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1073746772.
Healthcare Provider's Profile
| Full Name | Mr Keith G Pemberton I |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 801 Summit Ave, Greensboro, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1073746772
- Provider Enumeration Date: 08/27/2009
- Last Update Date: 08/27/2009
Medical Identifiers
Medical identifiers for Mr Keith G Pemberton I such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073746772 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | P003878 (North Carolina) | Secondary |
| 104100000X | Social Worker | P003878 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | P003878 (North Carolina) | Primary |
| 1041S0200X | Social Worker - School | (North Carolina) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Keith G Pemberton I is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Keith G Pemberton I, MSW, P-LCSW
1589 Skeet Club Rd, Suite 102-251,
High Point, NC 27265-8817
Ph: (336) 420-5366 | Mr Keith G Pemberton I, MSW, P-LCSW
801 Summit Ave, Suite 4,
Greensboro, NC 27405-7856
Ph: (336) 674-9781 |
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