Provider Demographics
NPI:1629523592
Name:GRANT, MARGARET ALLEY (LCSW-A)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ALLEY
Last Name:GRANT
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W SEEMAN ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1936
Mailing Address - Country:US
Mailing Address - Phone:540-230-1608
Mailing Address - Fax:
Practice Address - Street 1:120 W SEEMAN ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1936
Practice Address - Country:US
Practice Address - Phone:540-230-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0109501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical