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NPI Code Detail

MEDICARE: JAMILA ANNE MCKOY LCSWA

MEDICARE: JAMILA ANNE MCKOY 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 WorkerP020021NC

General Provider Information

NPI Number : 1932943156
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMILA ANNE MCKOY LCSWA
Provider Business Mailing Address
First Line : 415 DUNSTAN AVE STE B
Second Line :
City : DURHAM
State : NC
Zip : 27707-2390
Country : US
Telephone Number : 984-377-8576
Fax Number :
Provider Business Practice Location Address
First Line : 415 DUNSTAN AVE STE B
Second Line :
City : DURHAM
State : NC
Zip : 27707-2390
Country : US
Telephone Number : 984-377-8576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2024
Last Update Date : 06/21/2024

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Directions to “ JAMILA ANNE MCKOY LCSWA” Practice Location

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