Provider Demographics
NPI:1821605148
Name:BRYANT-RENFRO, PATRICIA (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BRYANT-RENFRO
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 1:3927 TOWNES BLVD
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:NC
Mailing Address - Zip Code:28682-8759
Mailing Address - Country:US
Mailing Address - Phone:828-320-3886
Mailing Address - Fax:
Practice Address - Street 1:260 1ST AVE NW STE 201
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-6161
Practice Address - Country:US
Practice Address - Phone:828-320-3886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0145001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical