MEDICARE: RYLEE PIERSON

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

General Provider Information

NPI Number	:	1841121324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYLEE PIERSON

Provider Business Mailing Address
First Line	:	553 NEW BERN STATION CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-1154
Country	:	US
Telephone Number	:	518-572-6408
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 MCCULLOUGH DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-3577
Country	:	US
Telephone Number	:	704-910-3260
Fax Number	:	980-422-0336

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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