| Loralie Grigas Msw Lcsw Lcas Pllc | |
|
1328 Lake Park Blvd N Ste 108e Carolina Beach NC 28428-3906 | |
| (910) 617-4675 | |
| (910) 469-0480 |
| Full Name | Loralie Grigas Msw Lcsw Lcas Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1328 Lake Park Blvd N Ste 108e, Carolina Beach, North Carolina |
| Authorized Official Name and Position | Loralie Grigas (MANAGING MEMBER) |
| Authorized Official Contact | 9106174675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loralie Grigas Msw Lcsw Lcas Pllc Po Box 16329 Wilmington NC 28408-6329 Ph: (910) 617-4675 | Loralie Grigas Msw Lcsw Lcas Pllc 1328 Lake Park Blvd N Ste 108e Carolina Beach NC 28428-3906 Ph: (910) 617-4675 |
| NPI Number | 1366891905 |
|---|---|
| Provider Enumeration Date | 06/05/2016 |
| Last Update Date | 04/24/2024 |
| Certification Date | 04/24/2024 |
| Medicare PECOS PAC ID | 5991073728 |
|---|---|
| Medicare Enrollment ID | O20170619002350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366891905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C006983 (North Carolina) | Primary |
| Provider Name | Loralie Grigas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558679639 PECOS PAC ID: 0840475778 Enrollment ID: I20110419000674 |
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