Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | SC60341247 | WA |
N | 1041C0700X | Clinical Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | SC60341247 | WA |
NPI | 1003158155 |
---|---|
Provider Name | Casey Paganucci |
First Address | Raleigh, NC 27612-7046 |
Second Address | Raleigh, NC 27603-2762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2013 |
Last Update Date | 14/12/2021 |