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General NPI Number Information
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NPI Number | 1083964258
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Entity Type | Individual
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Provider Name | ETHAN ARMSTRONG LCSWA
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Gender | Male
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3012 FALSTAFF RD
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City | RALEIGH
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State | NC
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Zip | 27610-1813
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Country | US
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Telephone | 919-615-1027
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Fax | 919-615-1501
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Provider Business Mailing Address
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Address Line | 3012 FALSTAFF RD
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City | RALEIGH
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State | NC
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Zip | 27610-1813
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Country | US
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Telephone | 919-799-9919
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Fax | 919-615-1027
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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 | P011458
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License Number State | NC
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