Healthcare Provider Details

I. General information

NPI: 1790034494
Provider Name (Legal Business Name): SCOTT GERARD CHERUBINO LCSW-A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 THOMAS HEIGHTS RD
FRANKLIN NC
28734-9799
US

IV. Provider business mailing address

100 THOMAS HEIGHTS RD
FRANKLIN NC
28734-9799
US

V. Phone/Fax

Practice location:
  • Phone: 828-524-9385
  • Fax:
Mailing address:
  • Phone: 828-524-9385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP006466
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: