Provider Demographics
NPI:1346279205
Name:EMORY, TERESA DREW (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:DREW
Last Name:EMORY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:DENISE
Other - Last Name:DREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:543 DOAN TOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-7270
Mailing Address - Country:US
Mailing Address - Phone:828-284-2287
Mailing Address - Fax:828-682-2119
Practice Address - Street 1:10 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-7270
Practice Address - Country:US
Practice Address - Phone:828-284-2287
Practice Address - Fax:828-682-2119
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0027471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC135VVOtherBCBSNC
NC6003047Medicaid
NC2868680BMedicare PIN