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General NPI Number Information
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NPI Number | 1003214461
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Entity Type | Individual
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Provider Name | MRS. LACRESHA BRUMFIELD
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Gender | Female
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 1108 LAWHORN RD
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-8974
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Country | US
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Telephone | 704-537-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 1427 VALANN FARM CT
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City | ROCK HILL
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State | SC
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Zip | 29732-2775
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Country | US
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Telephone | 803-467-5723
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C009525
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11415
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License Number State | SC
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