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General NPI Number Information
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NPI Number | 1588218648
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Entity Type | Individual
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Provider Name | ORRIN ANTHONY BYNES MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/27/2019
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 175 W FRANKLIN BLVD
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City | GASTONIA
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State | NC
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Zip | 28052-4145
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Country | US
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Telephone | 704-865-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 8504 WESTHOPE ST
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City | CHARLOTTE
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State | NC
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Zip | 28216-3692
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Country | US
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Telephone | 336-471-7595
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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 | P013559
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License Number State | NC
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