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General NPI Number Information
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NPI Number | 1790675445
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Entity Type | Individual
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Provider Name | COURTNEY CREASY PATE LCSWA
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Gender | Female
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Dates
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Enumeration Date | 07/05/2025
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Last Update Date | 07/05/2025
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Provider Practice Location Address
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Address Line | 2432 S CHURCH ST
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City | BURLINGTON
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State | NC
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Zip | 27215-5291
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Country | US
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Telephone | 336-494-8856
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Fax |
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Provider Business Mailing Address
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Address Line | 136 GEORGETOWNE DR
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City | ELON
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State | NC
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Zip | 27244-8314
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Country | US
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Telephone | 336-539-1648
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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 | PO22188
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License Number State | NC
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