Provider Demographics
NPI:1295117760
Name:ROLLE, CEMETRIUS TEOUNA (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:CEMETRIUS
Middle Name:TEOUNA
Last Name:ROLLE
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8825 UNIVERSITY EAST DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4395
Mailing Address - Country:US
Mailing Address - Phone:980-833-1121
Mailing Address - Fax:
Practice Address - Street 1:2302 W MEADOWVIEW RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3721
Practice Address - Country:US
Practice Address - Phone:336-852-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0097811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904011711Medicaid