Doctor Name: | MISS TRACI MICHELLE GESCAK |
NPI Number: | 1437306065 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P-LCSW |
License Number: | P003736 |
Business Practice Address: | 300 Veasey Dr. Butner, NC - 27509 |
Business Phone Number: | 9197645445 |
Business Fax Number: | 9197645199 |
Mailing Address: | 300 Veasey Dr., BUTNER |
State: | NC |
Postal Code: | 27509 |
Phone Number: | 9197645445 |
Fax Number: | 9197645199 |
NPI Enumeration Date: | 08/26/2008 |
NPI Last Update Date: | 08/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | P003736 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |