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General NPI Number Information
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NPI Number | 1346393089
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Entity Type | Individual
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Provider Name | TENA HICKS LESTER MSW LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 425 HWY 65 ROCKINGTON CO MENTAL HEALTH
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City | REIDSVILLE
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State | NC
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Zip | 27320
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Country | US
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Telephone | 336-342-9115
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Fax | 336-342-8457
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Provider Business Mailing Address
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Address Line | 140 WOODBRIAR DRIVE
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City | STONEVILLE
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State | NC
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Zip | 27048
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Country | US
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Telephone | 336-342-9115
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Fax | 336-342-8457
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | C005472
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License Number State | NC
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