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Individual

MR. DANIEL SHAWN AYERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
211 E SIX FORKS RD, STE105, RALEIGH, NC 27609-7745
(919) 368-3172
Mailing address
7833 MELCOMBE WAY, WAKE FOREST, NC 27587-5325
(919) 556-5787

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004952
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140GW
BLUE CROSS BLUE SHIELD NC
NC
01
369322
MHN
NC
05
6003399
NC
Enumeration date
08/31/2006
Last updated
11/14/2012
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