| Jennifer Upchurch Lcsw Pllc | |
|
7741 Market St Ste A Wilmington NC 28411-9444 | |
| (910) 228-8522 | |
| Not Available |
| Full Name | Jennifer Upchurch Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 7741 Market St Ste A, Wilmington, North Carolina |
| Authorized Official Name and Position | Jennifer Upchurch (OWNER) |
| Authorized Official Contact | 9102288522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Upchurch Lcsw Pllc 7741 Market St Ste A Wilmington NC 28411-9444 Ph: (910) 228-8522 | Jennifer Upchurch Lcsw Pllc 7741 Market St Ste A Wilmington NC 28411-9444 Ph: (910) 228-8522 |
| NPI Number | 1265016422 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Medicare PECOS PAC ID | 8325449036 |
|---|---|
| Medicare Enrollment ID | O20210701000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265016422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer Upchurch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023109337 PECOS PAC ID: 9133140247 Enrollment ID: I20051215000740 |
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