Provider Demographics
NPI:1467983726
Name:SCALES, GENEVA NICOLE (LCSWA)
Entity Type:Individual
Prefix:
First Name:GENEVA
Middle Name:NICOLE
Last Name:SCALES
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 1:1319 N BRIGHTLEAF BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4876
Mailing Address - Country:US
Mailing Address - Phone:919-934-1314
Mailing Address - Fax:919-934-9108
Practice Address - Street 1:249 E NC HIGHWAY 54 STE 320
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2490
Practice Address - Country:US
Practice Address - Phone:919-907-3334
Practice Address - Fax:919-907-3335
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0138001041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty