Provider Demographics
NPI:1265275671
Name:WESLEY, SAMERIA DANIELLE (MSW LCSWA)
Entity type:Individual
Prefix:MRS
First Name:SAMERIA
Middle Name:DANIELLE
Last Name:WESLEY
Suffix:
Gender:F
Credentials:MSW LCSWA
Other - Prefix:
Other - First Name:SAMERIA
Other - Middle Name:DANIELLE
Other - Last Name:SHIPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSWA
Mailing Address - Street 1:5729 IVANHOE CT APT 13
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-4493
Mailing Address - Country:US
Mailing Address - Phone:910-874-5993
Mailing Address - Fax:
Practice Address - Street 1:5729 IVANHOE CT APT 13
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-4493
Practice Address - Country:US
Practice Address - Phone:910-874-5993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0184301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical