Healthcare Provider Details

I. General information

NPI: 1497718985
Provider Name (Legal Business Name): JAMES GADSBY EMMETT MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRENNER AVE
SALISBURY NC
28144-2515
US

IV. Provider business mailing address

310 CAMELOT RD
SALISBURY NC
28147-8933
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-9000
  • Fax: 704-638-3434
Mailing address:
  • Phone: 704-636-9530
  • Fax: 704-638-3434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number001877
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: