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NPI Code Detail

MEDICARE: SARINA MANIFOLD LCSW

MEDICARE: SARINA MANIFOLD 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 Worker0000005881TN
21041C0700XClinical Social WorkerC012061NC

General Provider Information

NPI Number : 1447778246
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARINA MANIFOLD LCSW
Provider Business Mailing Address
First Line : 5540 CENTERVIEW DR STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27606-3386
Country : US
Telephone Number : 919-612-1991
Fax Number :
Provider Business Practice Location Address
First Line : 5540 CENTERVIEW DR STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27606-3386
Country : US
Telephone Number : 919-612-1991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2017
Last Update Date : 01/16/2023

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