Provider Demographics
NPI:1891204913
Name:DEMPS, TE'HA (LCSW)
Entity Type:Individual
Prefix:
First Name:TE'HA
Middle Name:
Last Name:DEMPS
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:PO BOX 1502
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28340-1102
Mailing Address - Country:US
Mailing Address - Phone:910-364-4191
Mailing Address - Fax:
Practice Address - Street 1:5803 COLD HARBOR CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4016
Practice Address - Country:US
Practice Address - Phone:910-364-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0113971041C0700X
NCC0128121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical