MEDICARE: ANTHONY ALLEN NEGRON 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
1	1041C0700X	Clinical Social Worker	C012129	NC

General Provider Information

NPI Number	:	1578698288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY ALLEN NEGRON LCSW

Provider Business Mailing Address
First Line	:	204 MUIRS CHAPEL RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-6173
Country	:	US
Telephone Number	:	336-355-6551
Fax Number	:	336-834-0442

Provider Business Practice Location Address
First Line	:	204 MUIRS CHAPEL RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-6173
Country	:	US
Telephone Number	:	336-355-6551
Fax Number	:	336-834-0442

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	05/09/2023

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