Michelina H Therrien Lcsw Pa | |
200 Valencia Dr Suite 101 Jacksonville NC 28546-6311 | |
(910) 355-1925 | |
(910) 355-1925 |
Full Name | Michelina H Therrien Lcsw Pa |
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Speciality | Social Worker |
Location | 200 Valencia Dr, Jacksonville, North Carolina |
Authorized Official Name and Position | Michelina H Therrien (PRESIDENT) |
Authorized Official Contact | 9103551925 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Michelina H Therrien Lcsw Pa 200 Valencia Dr Suite 101 Jacksonville NC 28546-6311 Ph: (910) 355-1925 | Michelina H Therrien Lcsw Pa 200 Valencia Dr Suite 101 Jacksonville NC 28546-6311 Ph: (910) 355-1925 |
NPI Number | 1437451747 |
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Provider Enumeration Date | 11/19/2010 |
Last Update Date | 11/19/2010 |
Medicare PECOS PAC ID | 2466640115 |
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Medicare Enrollment ID | O20101221001097 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437451747 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | C005474 (North Carolina) | Primary |
Provider Name | Michelina H Therrien |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1275677791 PECOS PAC ID: 1254379886 Enrollment ID: I20070815000431 |
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