Illyana Antoinese Massey, LCSWA
Social Worker, Clinical in Cary, NC. Individual provider (NPI-1).
NPI number1003548975
StatusActive
Last updated in NPPESJun 28, 2022
Details
- NPI
- 1003548975
- Entity type
- Individual (NPI-1)
- Name
- Illyana Antoinese Massey
- Credential
- LCSWA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2022
- Certification date
- Jun 27, 2022
- Last updated
- Jun 28, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | P017614 | NC | Yes |
Practice location
106 Fountain Brook Cir Ste BCary, NC 27511-4478
Phone 980-328-1775
Mailing address
2814 Vanstory St Apt 3cGreensboro, NC 27407-4797
Phone 980-328-1775
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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