Provider Demographics
NPI:1073953980
Name:MONSELL-GORBAS, VICKIE A (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:A
Last Name:MONSELL-GORBAS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 CHAPEL HILL RD
Mailing Address - Street 2:DURHAM
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1175
Mailing Address - Country:US
Mailing Address - Phone:919-401-8000
Mailing Address - Fax:919-401-8006
Practice Address - Street 1:1803 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1175
Practice Address - Country:US
Practice Address - Phone:919-401-8000
Practice Address - Fax:919-401-8006
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079898104100000X
NCP0086991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker