1649470865 NPI number — MRS. JOANNA MICHELE GARCIA NUNEZ MSW, LCAS, LCSW

Table of content: MRS. JOANNA MICHELE GARCIA NUNEZ MSW, LCAS, LCSW (NPI 1649470865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649470865 NPI number — MRS. JOANNA MICHELE GARCIA NUNEZ MSW, LCAS, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NUNEZ
Provider First Name:
JOANNA
Provider Middle Name:
MICHELE GARCIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCAS, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARCIA
Provider Other First Name:
JOANNA
Provider Other Middle Name:
MICHELE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649470865
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 262
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STEDMAN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28391-0262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-483-0005
Provider Business Mailing Address Fax Number:
910-483-0045

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505B OWEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304-3433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-483-0005
Provider Business Practice Location Address Fax Number:
910-483-0045
Provider Enumeration Date:
07/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  LCAS 1437 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: C006542 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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