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General NPI Number Information
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NPI Number | 1881357200
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Entity Type | Organization
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Legal Business Name | TORI NIEUSMA, LCSW, PLLC
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 1213 CULBRETH DR STE 338
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City | WILMINGTON
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State | NC
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Zip | 28405-3639
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Country | US
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Telephone | 910-741-5089
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Fax |
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Provider Business Mailing Address
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Address Line | 206 J BELTON CT
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City | SNEADS FERRY
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State | NC
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Zip | 28460-4200
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Country | US
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Telephone | 517-748-1004
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TORI NIEUSMA
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Credential | MSW, LCSW
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Telephone | 517-748-1004
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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 |
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