Provider Demographics
NPI:1497017347
Name:LEMMON, NICHOLAS GRANT (PLCSW)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:GRANT
Last Name:LEMMON
Suffix:
Gender:M
Credentials:PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6123 FARRINGTON RD APT M15
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8014
Mailing Address - Country:US
Mailing Address - Phone:704-608-1590
Mailing Address - Fax:
Practice Address - Street 1:138 S STEELE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4201
Practice Address - Country:US
Practice Address - Phone:919-776-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0074231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical