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NPI Code Detail

MEDICARE: MS. PRISCILLA YVONNE BLEVINS MSW LCSW

MEDICARE:  MS. PRISCILLA YVONNE BLEVINS  MSW 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 WorkerC003355NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2137F8OTHERNCBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1396880399
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PRISCILLA YVONNE BLEVINS MSW LCSW
Provider Business Mailing Address
First Line : PO BOX 15409
Second Line :
City : NEW BERN
State : NC
Zip : 28561-5409
Country : US
Telephone Number : 252-638-0123
Fax Number : 252-638-1996
Provider Business Practice Location Address
First Line : 1315 S GLENBURNIE RD
Second Line : SUITE C-13
City : NEW BERN
State : NC
Zip : 28562-2613
Country : US
Telephone Number : 252-638-0123
Fax Number : 252-638-1996
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/07/2008

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Directions to “ MS. PRISCILLA YVONNE BLEVINS MSW LCSW” Practice Location

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