Individual provider Active NPI

Erin Haverkamp

  • Clinical Social Worker
  • Mooresville, NC
National Provider Identifier
1003282021
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
122 Gateway Blvd Ste C
Mooresville, NC 28117-5544
Phone
(704) 360-3637
Fax
(704) 360-3637
NPI assigned
Aug 13, 2015
Last updated
Mar 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

122 Gateway Blvd Ste C
Mooresville, NC 28117-5544

Mailing address

PO Box 4962
Mooresville, NC 28117-4962
Phone (704) 360-3637

Other practice location 1

5050 Madison Rd
Cincinnati, OH 45227-1491
Phone (513) 272-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Asheli Thompson CurrentSince Apr 1, 2020 Accepting new patients

Locations

122 Gateway Blvd
Ste C
Mooresville, NC 28117
Phone (980) 766-1030

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1003282021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4962",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174962",
            "telephone_number": "704-360-3637",
            "fax_number": "704-360-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 GATEWAY BLVD STE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175544",
            "telephone_number": "704-360-3637",
            "fax_number": "704-360-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 Madison Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452271491",
            "country_code": "US",
            "telephone_number": "513-272-2800",
            "fax_number": "513-631-7484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVERKAMP",
        "first_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.