| Amity Storm Hines, | |
|
208 Malloy St Ste B, Goldsboro, NC 27534-4478 | |
| (984) 520-6080 | |
| Not Available |
| Full Name | Amity Storm Hines |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 10 Years |
| Location | 208 Malloy St Ste B, Goldsboro, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639790876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | P014387 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C014986 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Goshen Medical Center Incorporated | 3173434479 | 96 |
| Entity Name | Goshen Medical Center Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962124974 PECOS PAC ID: 3173434479 Enrollment ID: O20040102000726 |
| Entity Name | Pride in North Carolina LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760420186 PECOS PAC ID: 9638105869 Enrollment ID: O20050711000558 |
| Mailing Address | Practice Location Address |
|---|---|
| Amity Storm Hines, 2670 Durham Chapel Hill Blvd, Durham, NC 27707-2829 Ph: Not Available | Amity Storm Hines, 208 Malloy St Ste B, Goldsboro, NC 27534-4478 Ph: (984) 520-6080 |
Jasmine Detrice Ellison, LCSW-A Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1503 Wayne Memorial Dr Ste E, Goldsboro, NC 27534 Phone: 919-587-0001 Fax: 919-587-0007 |
Ms. Lakisha King, LCSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1318 Wayne Memorial Dr, Suite A & B, Goldsboro, NC 27534 Phone: 919-734-0753 |
Mr. Jerome L Ellis, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2803 Medical Campus Dr., Seymour Johnson Afb, Goldsboro, NC 27531 Phone: 919-722-0969 |
Comatha B Johnson, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1705 N Berkeley Blvd, Goldsboro, NC 27534 Phone: 919-751-0277 Fax: 919-751-0278 |
Pattie Lou Jones, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1706 Wayne Memorial Dr, Goldsboro, NC 27534 Phone: 919-734-6676 |
Ms. Krystal Danielle Bullard, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2803 Medical Campus Drive, Goldsboro, NC 27531 Phone: 919-722-1802 |
Ms. Brianna Nicole Davis, LCSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1606 Boyette Dr, Goldsboro, NC 27534 Phone: 919-394-3801 |