MEDICARE: JAZANAE BILLINGS BSW, 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
1	1041C0700X	Clinical Social Worker	P019631	NC

General Provider Information

NPI Number	:	1780469817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZANAE BILLINGS BSW, MSW, LCSWA

Provider Business Mailing Address
First Line	:	84 HONEYSUCKLE DR
Second Line	:
City	:	PITTSBORO
State	:	NC
Zip	:	27312-4100
Country	:	US
Telephone Number	:	984-248-8152
Fax Number	:

Provider Business Practice Location Address
First Line	:	2413 ROBESON ST STE 7
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5500
Country	:	US
Telephone Number	:	910-491-1758
Fax Number	:

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

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	08/28/2023

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