Individual
AMY JEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2725 CLOVER RD NW, CONCORD, NC 28027-3804
(704) 788-4300
Mailing address
4401 OLD AIRPORT RD, CONCORD, NC 28025-7188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C009196
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C009196
NORTH CAROLINA SOCIAL WORK AND LICENSURE BOARD
NC
Enumeration date
09/22/2014
Last updated
10/21/2014
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