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NPI Code Detail

MEDICARE: BERTA CHAVEZ LCSW

MEDICARE:   BERTA  CHAVEZ  LCSW
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 WorkerC014558NC

General Provider Information

NPI Number : 1144861741
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERTA CHAVEZ LCSW
Provider Business Mailing Address
First Line : 233 SILVER HILLS DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-8749
Country : US
Telephone Number : 910-265-9992
Fax Number :
Provider Business Practice Location Address
First Line : 200 VALENCIA DR STE 109
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6312
Country : US
Telephone Number : 910-330-7559
Fax Number : 910-996-0777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2019
Last Update Date : 12/09/2024

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Directions to “ BERTA CHAVEZ LCSW” Practice Location

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