Virgin, Telia Yevette

Virgin, Telia Yevette is an individual health care provider with primary practice located at 111 Willowcroft Ct , Garner NC 27529-7526. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Virgin, Telia Yevette can be contacted via phone (919) 841-3675.

Contact Information

Primary practice address
111 Willowcroft Ct Garner NC 27529-7526
Phone: (919) 841-3675
Fax: (919) 779-4498
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C005273 North Carolina
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X C005273 North Carolina

Profile Details

NPI number 1235291675
LBN Legal business name Virgin, Telia Yevette
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Jan 19th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235291675 NPPES
North Carolina MEDICAID 6106668

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