Provider Demographics
NPI:1811075872
Name:WOMACK, JOANN PORTER (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:PORTER
Last Name:WOMACK
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 1:383 STAMEY MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-5624
Mailing Address - Country:US
Mailing Address - Phone:828-369-8647
Mailing Address - Fax:
Practice Address - Street 1:175 SLOAN RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7391
Practice Address - Country:US
Practice Address - Phone:828-349-4137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0016841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1012TOtherBCBSNC
NC1012TOtherBCBSNC