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General NPI Number Information
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NPI Number | 1053687830
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Entity Type | Organization
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Legal Business Name | MICHELE HANCOCK LCSW & ASSOC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 3711 W MARKET ST UNIT B
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City | GREENSBORO
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State | NC
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Zip | 27403-4436
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Country | US
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Telephone | 336-554-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 4125 SHERIDAN RD
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City | GREENSBORO
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State | NC
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Zip | 27455-2441
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MICHELE LEE HANCOCK
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Credential | MSW, LCSW
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Telephone | 336-554-2220
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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 | C003650
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License Number State | NC
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