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NPI Code Detail

MEDICARE: MS. DANA NICCOLE ROBERTSON LCSW

MEDICARE: MS. DANA NICCOLE ROBERTSON 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 WorkerC003679NC

Other Identifiers

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

General Provider Information

NPI Number : 1184791337
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DANA NICCOLE ROBERTSON LCSW
Provider Business Mailing Address
First Line : 101 DEERTRACK DR
Second Line :
City : MOUNT HOLLY
State : NC
Zip : 28120-9423
Country : US
Telephone Number : 704-822-0938
Fax Number :
Provider Business Practice Location Address
First Line : 901 S NEW HOPE RD
Second Line :
City : GASTONIA
State : NC
Zip : 28054-5829
Country : US
Telephone Number : 704-884-2501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/08/2007

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