Provider Demographics
NPI:1396974325
Name:POMPEY, AUGUSTINA LANA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AUGUSTINA
Middle Name:LANA
Last Name:POMPEY
Suffix:
Gender:F
Credentials:LCSW
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Other - Credentials:
Mailing Address - Street 1:WOMACK ARMY MEDICAL CTR
Mailing Address - Street 2:2817 REILLY ROAD MCXC-COD CREDENTIALS
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-9645
Mailing Address - Fax:910-907-6069
Practice Address - Street 1:WOMACK ARMY MEDICAL CTR
Practice Address - Street 2:2817 REILLY ROAD MCXC-COD CREDENTIALS
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-9645
Practice Address - Fax:910-907-6069
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC056306164W00000X
NCC0074151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEQ1-0001030OtherSTATE OF DELAWARE BOARD OF CLINICAL SOCIAL WORK EXAMINERS
NC056306OtherNORTH CAROLINA BOARD OF NURSING
NCC007415OtherNORTH CAROLINA SOCIAL WORK BOARD