Basic Information
Provider Information
NPI: 1841911898
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HERRING
FirstName: LAINEY
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: LCSW-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3411 BRUSHY HILL RD
Address2:  
City: FAYETTEVILLE
State: NC
PostalCode: 283065662
CountryCode: US
TelephoneNumber: 9103363875
FaxNumber:  
Practice Location
Address1: 901 ARSENAL AVE STE 202
Address2:  
City: FAYETTEVILLE
State: NC
PostalCode: 283055478
CountryCode: US
TelephoneNumber: 9103233368
FaxNumber: 9104867000
Other Information
ProviderEnumerationDate: 09/08/2022
LastUpdateDate: 09/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  Y Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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