Provider Demographics
NPI:1245834027
Name:PERMISON, GLORIA MERCEDES (LCSW)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:MERCEDES
Last Name:PERMISON
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 1:7427 MATTHEWS MINT HILL RD STE 105-314
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7862
Mailing Address - Country:US
Mailing Address - Phone:980-372-4150
Mailing Address - Fax:
Practice Address - Street 1:7427 MATTHEWS MINT HILL RD STE 105-314
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-7862
Practice Address - Country:US
Practice Address - Phone:980-372-4150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058796001041C0700X
NJ1041S0200X
NCC0162471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool