Individual
MR. LAWRENCE A. ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSSW, LCSW
Contact information
Practice address
8520 SIX FORKS RD, SUITE 104, RALEIGH, NC 27615-3095
(919) 815-4984
Mailing address
5104 BRIDGET DR, RALEIGH, NC 27603-9332
(919) 779-2964
(919) 212-7826
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C001070
NC
Other
Enumeration date
08/18/2006
Last updated
07/29/2015
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