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NPI Code Detail

MEDICARE: SHENAE MARIYAH MONCRIEF LCSWA

MEDICARE:   SHENAE MARIYAH MONCRIEF  LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP01903NC

General Provider Information

NPI Number : 1508548348
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHENAE MARIYAH MONCRIEF LCSWA
Provider Business Mailing Address
First Line : 836 CHARLES CT
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27107-5355
Country : US
Telephone Number : 336-986-5889
Fax Number :
Provider Business Practice Location Address
First Line : 500 W NORTHWEST BLVD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27105-6526
Country : US
Telephone Number : 336-748-9028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2023
Last Update Date : 08/02/2023

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Directions to “ SHENAE MARIYAH MONCRIEF LCSWA” Practice Location

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