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NPI Code Detail

MEDICARE: ADRIANA LONDONO LCSWA, LCASA

MEDICARE:   ADRIANA  LONDONO  LCSWA, LCASA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-26560NC
21041C0700XClinical Social WorkerC015556NC

General Provider Information

NPI Number : 1831704691
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIANA LONDONO LCSWA, LCASA
Provider Business Mailing Address
First Line : 6936 WADSWORTH PL
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28314-1172
Country : US
Telephone Number : 910-723-7748
Fax Number :
Provider Business Practice Location Address
First Line : 418 PERSON ST STE 103
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5886
Country : US
Telephone Number : 910-483-0958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2020
Last Update Date : 04/07/2023

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