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NPI Code Detail

MEDICARE: TINA BERRIEN MSW,LCSWA

MEDICARE: TINA BERRIEN MSW,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 WorkerP012151NC

General Provider Information

NPI Number : 1629627526
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA BERRIEN MSW,LCSWA
Provider Business Mailing Address
First Line : 2205 E INDIANA AVE
Second Line :
City : SOUTHERN PINES
State : NC
Zip : 28387-7407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7489 ROCKFISH RD
Second Line :
City : RAEFORD
State : NC
Zip : 28376-6131
Country : US
Telephone Number : 910-584-6739
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2019
Last Update Date : 09/04/2019

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