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NPI Code Detail

MEDICARE: ELLYN SEMCHENKO LCSWA

MEDICARE: ELLYN SEMCHENKO LCSWA
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 WorkerP020820NC

General Provider Information

NPI Number : 1609614072
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLYN SEMCHENKO LCSWA
Provider Business Mailing Address
First Line : 4494 PIEDMONT TRACE DR
Second Line :
City : GREENSBORO
State : NC
Zip : 27409-9200
Country : US
Telephone Number : 701-836-2004
Fax Number :
Provider Business Practice Location Address
First Line : 3000 BETHESDA PL STE 501
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-3327
Country : US
Telephone Number : 336-332-2277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2024
Last Update Date : 07/18/2024

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Directions to “ ELLYN SEMCHENKO LCSWA” Practice Location

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