Healthcare Provider Details

I. General information

NPI: 1215303631
Provider Name (Legal Business Name): MEGHAN HEMINGWAY MSW, LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7609 FALCON REST CIR
RALEIGH NC
27615-2560
US

IV. Provider business mailing address

7609 FALCON REST CIR
RALEIGH NC
27615-2560
US

V. Phone/Fax

Practice location:
  • Phone: 919-815-1071
  • Fax:
Mailing address:
  • Phone: 919-815-1071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP009206
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: