Jon Wayne Eccleston in Indian Trail - Clinical
Jon Wayne Eccleston - NPI 1306937750
Jon Wayne Eccleston is a Clinical in Indian Trail, North Carolina. Jon Wayne Eccleston practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jon Wayne Eccleston is 1306937750. The last update date is 2011-09-21.
Jon Wayne Eccleston's current location address is 124 Unionville Indian Trl Rd W, Indian Trail, North Carolina. You can contact this provider via phone number 7046080445 and fax number 7048219337. The mailing address for Jon Wayne Eccleston is 124 Unionville Indian Trl Rd W, Indian Trail, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jon Wayne Eccleston |
|---|---|
| Address | 124 Unionville Indian Trl Rd W, Indian Trail, North Carolina |
| Phone Number | 7046080445 |
| Fax Number | 7048219337 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1306937750 |
|---|---|
| Provider Enumeration Date | 2006-09-28 |
| Last Updated Date | 2011-09-21 |
Provider Mailing Address Detail
| Address | 124 Unionville Indian Trl Rd W |
|---|---|
| City | Indian Trail |
| State | North Carolina (NC) |
| Post Code | 280795591 |
| Phone Number | 7046080445 |
| Fax Number | 7048219337 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | C004734 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| C004734 | NC | NC CLINICAL SOCIAL WORK | |
| 600913 | NC | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Jon Wayne Eccleston by the Centers for Medicare & Medicaid Services (CMS)?
The Jon Wayne Eccleston has been assigned the NPI (National Provider Identifier) 1306937750. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Jon Wayne Eccleston?
The Jon Wayne Eccleston is physically situated at 124 Unionville Indian Trl Rd W, in the city of Indian Trail, state of NC, with the postal code 280795591.
What is the area of specialization for Jon Wayne Eccleston, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jon Wayne Eccleston is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1306937750 to Jon Wayne Eccleston?
The Jon Wayne Eccleston received its 1306937750 assignment from the Centers for Medicare & Medicaid Services on 2006-09-28.
When was the information regarding Jon Wayne Eccleston most recently updated?
The details pertaining to the Jon Wayne Eccleston, including its address, specialty, and other relevant information, were last refreshed on 2011-09-21.