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NPI Code Detail

MEDICARE: MS. JAMEY MARINA MSW, LCSW-A

MEDICARE: MS. JAMEY MARINA MSW, LCSW-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
11041C0700XClinical Social WorkerP009269NC

General Provider Information

NPI Number : 1336526847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JAMEY MARINA MSW, LCSW-A
Provider Business Mailing Address
First Line : 1797 GEIBERGER DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28303-6225
Country : US
Telephone Number : 910-273-7032
Fax Number :
Provider Business Practice Location Address
First Line : 401 ROBESON ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5635
Country : US
Telephone Number : 910-491-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2015
Last Update Date : 05/04/2015

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