Provider Demographics
NPI:1811243447
Name:HUSS, PATRICIA NICOLE (LCSW-A, MSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:NICOLE
Last Name:HUSS
Suffix:
Gender:F
Credentials:LCSW-A, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 MECUM RD
Mailing Address - Street 2:
Mailing Address - City:WALKERTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27051-9348
Mailing Address - Country:US
Mailing Address - Phone:336-456-1056
Mailing Address - Fax:336-285-7178
Practice Address - Street 1:1 CENTERVIEW DR STE 307
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3712
Practice Address - Country:US
Practice Address - Phone:336-285-7176
Practice Address - Fax:336-285-7178
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0073811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical