Provider Demographics
NPI:1346393089
Name:LESTER, TENA HICKS (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TENA
Middle Name:HICKS
Last Name:LESTER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WOODBRIAR DRIVE
Mailing Address - Street 2:
Mailing Address - City:STONEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27048
Mailing Address - Country:US
Mailing Address - Phone:336-342-9115
Mailing Address - Fax:336-342-8457
Practice Address - Street 1:425 HWY 65
Practice Address - Street 2:ROCKINGTON CO MENTAL HEALTH
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320
Practice Address - Country:US
Practice Address - Phone:336-342-9115
Practice Address - Fax:336-342-8457
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005472104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker