Provider Demographics
NPI:1932187754
Name:TOEPFER, ROSWITA M
Entity Type:Individual
Prefix:MRS
First Name:ROSWITA
Middle Name:M
Last Name:TOEPFER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ROSWITA
Other - Middle Name:M
Other - Last Name:TOEPFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW LMFT
Mailing Address - Street 1:1405 DUNCAN ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-3726
Mailing Address - Country:US
Mailing Address - Phone:910-488-4483
Mailing Address - Fax:910-488-4384
Practice Address - Street 1:1405 DUNCAN ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3726
Practice Address - Country:US
Practice Address - Phone:910-488-4483
Practice Address - Fax:910-488-4384
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0012991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002397Medicaid