Provider Demographics
NPI:1992554307
Name:XAVIER, ANN ROSE (LCSW-A)
Entity type:Individual
Prefix:MS
First Name:ANN ROSE
Middle Name:
Last Name:XAVIER
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DUNSTAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2390
Mailing Address - Country:US
Mailing Address - Phone:833-496-0445
Mailing Address - Fax:984-208-5220
Practice Address - Street 1:415 DUNSTAN AVE STE B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2390
Practice Address - Country:US
Practice Address - Phone:833-496-0445
Practice Address - Fax:984-208-5220
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0203411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical