Provider Demographics
NPI:1043214885
Name:ZEIBER, RICHARD R (ACSW, LCSW)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:ZEIBER
Suffix:
Gender:M
Credentials:ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40236
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-0236
Mailing Address - Country:US
Mailing Address - Phone:910-635-8076
Mailing Address - Fax:910-429-0777
Practice Address - Street 1:2545 RAVENHILL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-9617
Practice Address - Country:US
Practice Address - Phone:910-635-8076
Practice Address - Fax:910-429-0777
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0002541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344099OtherMHN -TRICARE
NC8989GOtherBCBS
NC6003298Medicaid
NC6003298Medicaid