Provider Demographics
NPI:1891882684
Name:VASU, NADIA MARIE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:MARIE
Last Name:VASU
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 KILMAYNE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4491
Mailing Address - Country:US
Mailing Address - Phone:919-699-1351
Mailing Address - Fax:919-651-1005
Practice Address - Street 1:301 KILMAYNE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4491
Practice Address - Country:US
Practice Address - Phone:919-699-1351
Practice Address - Fax:919-651-1005
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0055331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical