Bumgardner, Carmellia Thomas

Bumgardner, Carmellia Thomas is an individual health care provider with primary practice located at 351 Riverside Dr , Mount Airy NC 27030-3850. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bumgardner, Carmellia Thomas can be contacted via phone (336) 786-7079.

Contact Information

Primary practice address
351 Riverside Dr Mount Airy NC 27030-3850
Phone: (336) 786-7079
Fax: (336) 786-6312
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C004066 North Carolina

Profile Details

NPI number 1770633679
LBN Legal business name Bumgardner, Carmellia Thomas
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated May 26th, 2017 - about 8 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 1770633679 NPPES
North Carolina MEDICAID 6003123

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