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General NPI Number Information
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NPI Number | 1649849654
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Entity Type | Individual
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Provider Name | MEGAN GRUBBS FISCHETTI LCSWA
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Gender | Female
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 447 S SHARON AMITY RD STE 105
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City | CHARLOTTE
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State | NC
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Zip | 28211-2836
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Country | US
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Telephone | 980-299-7436
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Fax | 980-226-5507
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Provider Business Mailing Address
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Address Line | 1540 PECAN AVE
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City | CHARLOTTE
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State | NC
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Zip | 28205-3452
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Country | US
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Telephone | 804-517-0795
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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 |
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License Number State | NC
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