Healthcare Provider Details

I. General information

NPI: 1194840165
Provider Name (Legal Business Name): VANNESSA CAIN GHARBI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 E WENDOVER AVE
GREENSBORO NC
27405-6712
US

IV. Provider business mailing address

202 N WESTGATE DR
GREENSBORO NC
27407-1228
US

V. Phone/Fax

Practice location:
  • Phone: 336-272-1050
  • Fax: 336-272-1110
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC005436
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number11296532
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: