Provider Demographics
NPI:1689288623
Name:CULBRETH, NIYA (LCSWA)
Entity type:Individual
Prefix:MS
First Name:NIYA
Middle Name:
Last Name:CULBRETH
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MS
Other - First Name:NIYA
Other - Middle Name:
Other - Last Name:CULBRETH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSWA
Mailing Address - Street 1:1613 FLINTSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4942
Mailing Address - Country:US
Mailing Address - Phone:910-964-2661
Mailing Address - Fax:
Practice Address - Street 1:3333 WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5631
Practice Address - Country:US
Practice Address - Phone:704-393-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0223331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical