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Organization
LAWRENCE A. ELLSWORTH, LCSW, PLLC
Active
Organization
LAWRENCE A. ELLSWORTH, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE A. ELLSWORTH LCSW (LICENSED CLINICAL SOCIAL WORKER)
(919) 815-4984
Entity
Organization
Contact information
Practice address
8520 SIX FORKS RD STE 104, RALEIGH, NC 27615-3096
(919) 815-4984
Mailing address
5104 BRIDGET DR, RALEIGH, NC 27603-9332
(919) 815-4984
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C001070
NC
Other
Enumeration date
06/28/2017
Last updated
03/17/2018
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