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NPI Code Detail

MEDICARE: VIRGINIA IVEY LEGGETT LCSW

MEDICARE: VIRGINIA IVEY LEGGETT 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 WorkerC003540NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932270220
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIRGINIA IVEY LEGGETT LCSW
Provider Business Mailing Address
First Line : 6800 SAINT PETERS LN
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-8458
Country : US
Telephone Number : 704-536-0375
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 : 11/10/2006
Last Update Date : 10/25/2017

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Directions to “ VIRGINIA IVEY LEGGETT LCSW” Practice Location

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