Provider Demographics
NPI:1134208804
Name:JAMES, PENNY C (MSW, LCSW, C-CATODSW)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:C
Last Name:JAMES
Suffix:
Gender:F
Credentials:MSW, LCSW, C-CATODSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BONNIE LANE
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779
Mailing Address - Country:US
Mailing Address - Phone:828-586-5501
Mailing Address - Fax:828-586-3965
Practice Address - Street 1:91 TIMBERLANE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-7927
Practice Address - Country:US
Practice Address - Phone:828-454-1098
Practice Address - Fax:828-454-9242
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106248Medicaid
NC6106248Medicaid