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General NPI Number Information
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NPI Number | 1871306977
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Entity Type | Individual
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Provider Name | MINDY SELF PHILBECK LCSWA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 806 N LAFAYETTE ST
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City | SHELBY
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State | NC
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Zip | 28150-3831
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Country | US
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Telephone | 704-487-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 123 ILLINOIS ST
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City | SPINDALE
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State | NC
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Zip | 28160-1908
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Country | US
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Telephone | 828-443-1569
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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 | P022213
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License Number State | NC
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