Healthcare Provider Details

I. General information

NPI: 1407194574
Provider Name (Legal Business Name): MIGDALIA ACEVEDO LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 UNIVERSITY DR SUITE C
DURHAM NC
27707-2654
US

IV. Provider business mailing address

100 HIDDEN OAKS DR APT. 3A
CARY NC
27513-3306
US

V. Phone/Fax

Practice location:
  • Phone: 919-405-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP007147
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: