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NPI Code Detail

MEDICARE: KRISTEN EILEEN PISCITELLI LCSWA

MEDICARE: KRISTEN EILEEN PISCITELLI LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP021163NC

General Provider Information

NPI Number : 1063243798
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN EILEEN PISCITELLI LCSWA
Provider Business Mailing Address
First Line : 6302 FAIRVIEW RD STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-2227
Country : US
Telephone Number : 704-584-9897
Fax Number :
Provider Business Practice Location Address
First Line : 6302 FAIRVIEW RD STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-2227
Country : US
Telephone Number : 704-584-9897
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2024
Last Update Date : 08/13/2024

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Directions to “ KRISTEN EILEEN PISCITELLI LCSWA” Practice Location

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