Provider Demographics
NPI:1396343729
Name:BIRCH, GEOFFREY JAMES (LCSW)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:JAMES
Last Name:BIRCH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 ASHLEY WOODS CT
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-9346
Mailing Address - Country:US
Mailing Address - Phone:860-214-6839
Mailing Address - Fax:
Practice Address - Street 1:1812 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1106
Practice Address - Country:US
Practice Address - Phone:919-576-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical