Individual
MRS. CORNELIA GOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-A
Contact information
Practice address
2106 HOPE MILLS RD, FAYETTEVILLE, NC 28304-4226
(910) 423-0128
(910) 423-0169
Mailing address
2106 HOPE MILLS RD, FAYETTEVILLE, NC 28304-4226
(910) 423-0128
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P015324
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P015324
NORTH CAROLINA SOCIAL WORK CERTIFICATION AND LICENSURE BOARD
NC
Enumeration date
10/08/2020
Last updated
10/08/2020
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