Provider Demographics
NPI:1336970920
Name:PHILPOT, ONISHA (LCSWA)
Entity type:Individual
Prefix:
First Name:ONISHA
Middle Name:
Last Name:PHILPOT
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 SNOWDEN DR SE # A
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-6473
Mailing Address - Country:US
Mailing Address - Phone:252-497-9927
Mailing Address - Fax:
Practice Address - Street 1:1701 SNOWDEN DR SE # A
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-6473
Practice Address - Country:US
Practice Address - Phone:252-497-9927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0209721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical