Provider Demographics
NPI:1588809883
Name:EASON, TWAYLA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:TWAYLA
Middle Name:
Last Name:EASON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 SPRING FOREST RD
Mailing Address - Street 2:APARTMENT 3
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2106
Mailing Address - Country:US
Mailing Address - Phone:252-531-1442
Mailing Address - Fax:
Practice Address - Street 1:1912 E FIRE TOWER RD
Practice Address - Street 2:SUITE 113
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4194
Practice Address - Country:US
Practice Address - Phone:252-355-5587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0062611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical