Masullo, Carmen Phillip

Masullo, Carmen Phillip is an sole proprietor health care provider with primary practice located at 1331 Wait Ave , Wake Forest NC 27587-6985. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Masullo, Carmen Phillip can be contacted via phone (919) 556-5407.

Contact Information

Primary practice address
1331 Wait Ave Wake Forest NC 27587-6985
Phone: (919) 556-5407
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C003315 North Carolina

Profile Details

NPI number 1639229511
LBN Legal business name Masullo, Carmen Phillip
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 11th, 2007
Last updated Oct 7th, 2013 - about 11 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 1639229511 NPPES
North Carolina MEDICAID 6003657

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