Provider Demographics
NPI:1366776197
Name:RAYNOR, MONICA HINSON (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:HINSON
Last Name:RAYNOR
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:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:905 JOHNS HOPKINS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2056
Practice Address - Country:US
Practice Address - Phone:252-744-1406
Practice Address - Fax:252-744-4243
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-27
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0046661041C0700X
NCC0073661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ57406AOtherMEDICARE
NC19QSROtherBCBS OF NC
NC1366776197Medicaid