Provider Demographics
NPI:1144542846
Name:ENGI, JACQUELINE ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ANNE
Last Name:ENGI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 ARBORETUM TRCE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9658
Mailing Address - Country:US
Mailing Address - Phone:919-771-4142
Mailing Address - Fax:
Practice Address - Street 1:5840 FARINGDON PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3930
Practice Address - Country:US
Practice Address - Phone:919-771-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0067091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical