MEDICARE: MRS. TANIKKA J GREENE-AKRIE 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
1	1041C0700X	Clinical Social Worker	P013168	NC

General Provider Information

NPI Number	:	1427614015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANIKKA J GREENE-AKRIE MSW, LCSW-A

Provider Business Mailing Address
First Line	:	4912 PATRICIA ANN LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0947
Country	:	US
Telephone Number	:	252-367-0492
Fax Number	:

Provider Business Practice Location Address
First Line	:	4912 PATRICIA ANN LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0947
Country	:	US
Telephone Number	:	252-367-0492
Fax Number	:

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

Provider Enumeration Date	:	05/19/2019
Last Update Date	:	05/19/2019

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