Provider Demographics
NPI:1053642710
Name:DAY, MILICENT LEWIS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MILICENT
Middle Name:LEWIS
Last Name:DAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N EUGENE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2221
Mailing Address - Country:US
Mailing Address - Phone:336-641-4993
Mailing Address - Fax:336-641-7544
Practice Address - Street 1:201 N EUGENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2221
Practice Address - Country:US
Practice Address - Phone:336-641-4993
Practice Address - Fax:336-641-7544
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0066561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007481Medicaid