MEDICARE: AMY D DROZDA MSW, LCSW

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
1	1041C0700X	Clinical Social Worker	I-06561	NM
2	1041C0700X	Clinical Social Worker	C008197	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760515688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY D DROZDA MSW, LCSW

Provider Business Mailing Address
First Line	:	1503 SUITE E WAYNE MEMORIAL DRIVE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-2203
Country	:	US
Telephone Number	:	919-587-0001
Fax Number	:	919-587-0007

Provider Business Practice Location Address
First Line	:	1503 WAYNE MEMORIAL DR
Second Line	:	SUITE E
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-2203
Country	:	US
Telephone Number	:	919-587-0001
Fax Number	:	919-587-0007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/19/2015

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