Healthcare Provider Details

I. General information

NPI: 1043483407
Provider Name (Legal Business Name): GUY W. TOWNE JR. BS, MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 12/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 SUNGATE BLVD
RALEIGH NC
27610-2871
US

IV. Provider business mailing address

3305 SUNGATE BLVD
RALEIGH NC
27610-2871
US

V. Phone/Fax

Practice location:
  • Phone: 919-212-0129
  • Fax: 919-255-1540
Mailing address:
  • Phone: 919-212-0129
  • Fax: 919-255-1540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006256
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: