Basic Information
| Provider Information | |||||||||
| NPI: | 1679708135 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WERTMAN | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 PERIMETER PARK DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | MORRISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275608442 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 118 KNOX WAY | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275166610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9842155900 | ||||||||
| FaxNumber: | 9842155942 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2009 | ||||||||
| LastUpdateDate: | 08/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | CW016243 | PA | N | Behavioral Health & Social Service Providers | Social Worker | 1041S0200X | CW016243 | PA | N | Behavioral Health & Social Service Providers | Social Worker | School | 1041C0700X | CW016243 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.