MEDICARE: MS. KIERRA EUNNICE THURMAN MSW, LCSW, LCAS-A

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	C020142	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C020142	OTHER	NC	NORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD

General Provider Information

NPI Number	:	1295084366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIERRA EUNNICE THURMAN MSW, LCSW, LCAS-A

Provider Business Mailing Address
First Line	:	6025 CARRARA PL APT 203
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-0831
Country	:	US
Telephone Number	:	704-676-2820
Fax Number	:

Provider Business Practice Location Address
First Line	:	6025 CARRARA PL APT 203
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-0831
Country	:	US
Telephone Number	:	704-676-2820
Fax Number	:

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

Provider Enumeration Date	:	09/05/2012
Last Update Date	:	06/07/2026

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