Healthcare Provider Details

I. General information

NPI: 1396573341
Provider Name (Legal Business Name): BRITTANY GAYLE YEARWOOD MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. BRITTANY GAYLE BALLARD

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 US 70 HWY E
GARNER NC
27529-3982
US

IV. Provider business mailing address

3421 RED BAY DR
RALEIGH NC
27616-8718
US

V. Phone/Fax

Practice location:
  • Phone: 919-791-5611
  • Fax: 919-342-8393
Mailing address:
  • Phone: 919-358-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP021336
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: