| Square One Counseling Pllc | |
|
505b Owen Dr Fayetteville NC 28304-3433 | |
| (910) 483-0005 | |
| (910) 483-0045 |
| Full Name | Square One Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 505b Owen Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Joanna Nunez (OWNER) |
| Authorized Official Contact | 9104830005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Square One Counseling Pllc Po Box 262 Stedman NC 28391-0262 Ph: (910) 483-0005 | Square One Counseling Pllc 505b Owen Dr Fayetteville NC 28304-3433 Ph: (910) 483-0005 |
| NPI Number | 1174848733 |
|---|---|
| Provider Enumeration Date | 04/07/2010 |
| Last Update Date | 06/28/2010 |
| Medicare PECOS PAC ID | 5890825764 |
|---|---|
| Medicare Enrollment ID | O20100621000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174848733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1437 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C006542 (North Carolina) | Primary |
| Provider Name | Joanna M Nunez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649470865 PECOS PAC ID: 1456482520 Enrollment ID: I20100706000789 |
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