| NPI | 1023539285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE A. ELLSWORTH Licensed Clinical Social Worker 919-815-4984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C001070) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2018-03-17 |