Provider Demographics
NPI:1518695824
Name:HORN, PHILIP (MSW MPH LCSW-A)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:HORN
Suffix:
Gender:M
Credentials:MSW MPH LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 CHAPEL HILL RD STE J
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5039
Mailing Address - Country:US
Mailing Address - Phone:440-344-3901
Mailing Address - Fax:919-573-0438
Practice Address - Street 1:18 W COLONY PL STE 110
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5582
Practice Address - Country:US
Practice Address - Phone:919-726-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-13
Last Update Date:2022-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0168551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical