Doctor Name: | MR. C JIM BYNUM |
NPI Number: | 1093764987 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | C004611 |
Business Practice Address: | 1900 Hwy 87, Unit G Navarre, FL - 325662831 |
Business Phone Number: | 8507103702 |
Business Fax Number: | 8507103702 |
Mailing Address: | 1900 Hwy 87, Unit G NAVARRE |
State: | FL |
Postal Code: | 325662831 |
Phone Number: | 9104948746 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2006 |
NPI Last Update Date: | 12/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | C004611 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |