Provider Demographics
NPI:1891940995
Name:WAUGAMAN, JAMIE NASH (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:NASH
Last Name:WAUGAMAN
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 1:239 IVY NECK RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27921-7568
Mailing Address - Country:US
Mailing Address - Phone:252-336-4860
Mailing Address - Fax:
Practice Address - Street 1:905 HALSTEAD BLVD STE 14
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-6815
Practice Address - Country:US
Practice Address - Phone:252-338-9006
Practice Address - Fax:252-331-2539
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0062311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical