Provider Demographics
NPI:1477080661
Name:BIGELOW, CARMELITA TIBURCIO (CLINICAL SOCIAL WORK)
Entity Type:Individual
Prefix:
First Name:CARMELITA
Middle Name:TIBURCIO
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 S CLIFFS CIR APT 303
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-3492
Mailing Address - Country:US
Mailing Address - Phone:910-777-4887
Mailing Address - Fax:
Practice Address - Street 1:4719 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2113
Practice Address - Country:US
Practice Address - Phone:910-739-0050
Practice Address - Fax:910-739-0077
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical