Healthcare Provider Details

I. General information

NPI: 1427785146
Provider Name (Legal Business Name): MARIA CAZARES RAMON LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1889 DUDLEY SHOALS RD
GRANITE FALLS NC
28630-8431
US

IV. Provider business mailing address

200 E SECOND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 828-396-8373
  • Fax:
Mailing address:
  • Phone: 704-874-1904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC016557
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: