MEDICARE: MICHAEL P CROITORU 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
1	1041C0700X	Clinical Social Worker	C012706	NC
2	1041C0700X	Clinical Social Worker	SW15534	FL
3	1041S0200X	School Social Worker	SW15534	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184192221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL P CROITORU LCSW

Provider Business Mailing Address
First Line	:	PO BOX 672
Second Line	:
City	:	ZEBULON
State	:	NC
Zip	:	27597-0672
Country	:	US
Telephone Number	:	919-275-2411
Fax Number	:

Provider Business Practice Location Address
First Line	:	713 N ARENDELL AVE
Second Line	:
City	:	ZEBULON
State	:	NC
Zip	:	27597-2303
Country	:	US
Telephone Number	:	919-275-2411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2018
Last Update Date	:	01/26/2024

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