Healthcare Provider Details

I. General information

NPI: 1528113305
Provider Name (Legal Business Name): TERESA A. GRECO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 04/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9003 WESTON PKWY
CARY NC
27513-2201
US

IV. Provider business mailing address

9003 WESTON PKWY
CARY NC
27513-2201
US

V. Phone/Fax

Practice location:
  • Phone: 919-677-1459
  • Fax: 919-677-1489
Mailing address:
  • Phone: 919-677-1459
  • Fax: 919-677-1489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004650
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6003341
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 2
Identifier1385R
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerBCBSNC
# 3
Identifier2231027
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerCIGNA
# 4
Identifier555120000
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerMAGELLAN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: