=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487428587
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARMAINE RAQUEL JOYNER MSW, LCSWA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2023
-----------------------------------------------------
Last Update Date | 11/08/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1310 CASPIAN DR
-----------------------------------------------------
City | KNIGHTDALE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27545-6380
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-804-0838
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5100 TRINITY GATE LN APT 206
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27607-3996
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-946-5608
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | P019872
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------