Provider Demographics
NPI:1750511127
Name:M. HOPE ROLLINS, LCSW, PLLC
Entity Type:Organization
Organization Name:M. HOPE ROLLINS, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:M
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:ROLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-239-4588
Mailing Address - Street 1:827 N BLOODWORTH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1231
Mailing Address - Country:US
Mailing Address - Phone:919-239-4588
Mailing Address - Fax:919-516-0558
Practice Address - Street 1:827 N BLOODWORTH ST
Practice Address - Street 2:SUITE A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1231
Practice Address - Country:US
Practice Address - Phone:919-239-4588
Practice Address - Fax:919-516-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0003451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2873514Medicare UPIN