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151 Poole Rd Ste 505 Belville NC 28451-9508 | |
| (914) 240-2220 | |
| (914) 344-5746 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 151 Poole Rd Ste 505, Belville, North Carolina |
| Authorized Official Name and Position | Elizabeth M Nabors (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9102402220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3520 Gladehill Ln Leland NC 28451-6511 Ph: (910) 240-2220 | 151 Poole Rd Ste 505 Belville NC 28451-9508 Ph: (914) 240-2220 |
| NPI Number | 1417448010 |
|---|---|
| Provider Enumeration Date | 05/20/2018 |
| Last Update Date | 09/25/2020 |
| Certification Date | 09/16/2020 |
| Medicare PECOS PAC ID | 0244582575 |
|---|---|
| Medicare Enrollment ID | O20181015000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417448010 | NPI | - | NPPES |
| C9633 | Other | MS | LICENSURE |
| C009445 | Other | NC | LICENSURE |
| 082236 | Other | NY | LICENSURE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth M Nabors |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942503586 PECOS PAC ID: 7113279449 Enrollment ID: I20181015001038 |