Provider Demographics
NPI:1770506420
Name:FOUSHEE, NANCY G (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:G
Last Name:FOUSHEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3077
Mailing Address - Country:US
Mailing Address - Phone:336-917-0022
Mailing Address - Fax:336-773-0332
Practice Address - Street 1:2910 BRIARCLIFF RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3077
Practice Address - Country:US
Practice Address - Phone:336-917-0022
Practice Address - Fax:336-773-0332
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0014041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical