Healthcare Provider Details

I. General information

NPI: 1467348912
Provider Name (Legal Business Name): REBECCA BARGAMIAN MSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 SIKES PL STE 325
CHARLOTTE NC
28277-8208
US

IV. Provider business mailing address

8225 DAVE MCKINNEY AVE UNIT 2401
CHARLOTTE NC
28213-5636
US

V. Phone/Fax

Practice location:
  • Phone: 704-247-7353
  • Fax:
Mailing address:
  • Phone: 224-733-9909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP022204
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: