Provider Demographics
NPI:1457005480
Name:JAMES, BETH (LCSWA)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 FOUR BROOKS RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-9655
Mailing Address - Country:US
Mailing Address - Phone:336-679-9236
Mailing Address - Fax:
Practice Address - Street 1:137 FOUR BROOKS RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-9655
Practice Address - Country:US
Practice Address - Phone:336-679-9236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP016998104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker