Provider Demographics
NPI:1053034249
Name:YAMOAH, ASANTEWAA (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:ASANTEWAA
Middle Name:
Last Name:YAMOAH
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 WORTH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-4049
Mailing Address - Country:US
Mailing Address - Phone:850-363-2544
Mailing Address - Fax:
Practice Address - Street 1:1107 WORTH ST UNIT A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4049
Practice Address - Country:US
Practice Address - Phone:850-363-2544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0178261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical