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NPI Code Detail

MEDICARE: NANCY MADENYIKA MSW, LCSW

MEDICARE: NANCY MADENYIKA MSW, 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 Worker0904015442VA
21041C0700XClinical Social WorkerC010092NC

General Provider Information

NPI Number : 1659794683
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY MADENYIKA MSW, LCSW
Provider Business Mailing Address
First Line : 4801 GLENWOOD AVE STE 200 PMB 515
Second Line :
City : RALEIGH
State : NC
Zip : 27612-3857
Country : US
Telephone Number : 919-960-7251
Fax Number :
Provider Business Practice Location Address
First Line : 4801 GLENWOOD AVE STE 200 PMB 515
Second Line :
City : RALEIGH
State : NC
Zip : 27612-3857
Country : US
Telephone Number : 919-960-7251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2014
Last Update Date : 02/21/2024

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