Provider Demographics
NPI:1376955468
Name:PALOMA, NADIA A (LCSW)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:A
Last Name:PALOMA
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 1:4705 UNIVERSITY DR BLDG 700
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3489
Mailing Address - Country:US
Mailing Address - Phone:919-237-1337
Mailing Address - Fax:919-237-1625
Practice Address - Street 1:4705 UNIVERSITY DR BLDG 700
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3489
Practice Address - Country:US
Practice Address - Phone:919-237-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP007987104100000X
NCLICENSEC0105601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1578604450OtherNPI2 EMPLOYER- TRIANGLE FAMILY SERVICES, INC.
NC1306297213OtherNPI 2 EMPLOYER SIMPLY THRIVE THERAPEUTIC ASSOCIATES PLLC
NCC010560OtherLCSW LICENSE