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NPI Code Detail

MEDICARE: MRS. GAY MAVERNY LAWRENCE LCSWA

MEDICARE: MRS. GAY MAVERNY LAWRENCE 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 WorkerP018519NC

General Provider Information

NPI Number : 1790901122
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GAY MAVERNY LAWRENCE LCSWA
Provider Business Mailing Address
First Line : 769 N WENDOVER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-1118
Country : US
Telephone Number : 704-376-7180
Fax Number :
Provider Business Practice Location Address
First Line : 769 N WENDOVER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-1118
Country : US
Telephone Number : 704-376-7180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 01/25/2023

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