Provider Demographics
NPI:1669964508
Name:BREEDEN, NATURAL MORGAN (LCSWA)
Entity type:Individual
Prefix:
First Name:NATURAL
Middle Name:MORGAN
Last Name:BREEDEN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 ATKINSON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28340-5400
Mailing Address - Country:US
Mailing Address - Phone:910-374-9518
Mailing Address - Fax:
Practice Address - Street 1:1534 ATKINSON RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340-5400
Practice Address - Country:US
Practice Address - Phone:910-374-9518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0125461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical