Individual provider Active NPI

Heather Campbell Wheeler, MSW, LCSW

  • Clinical Social Worker
  • New Bern, NC
National Provider Identifier
1013097898
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
COO4946 Issued in NC
Practice address
1401 Park Ave
New Bern, NC 28560-5502
Phone
(252) 229-9053
Fax
(252) 648-8381
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X COO4946 NC Primary

Addresses

Primary practice location

1401 Park Ave
New Bern, NC 28560-5502

Mailing address

107 Oak Dr
Morehead City, NC 28557-9634
Phone (252) 229-9053

Other identifiers 1

IdentifierTypeStateIssuer
6003592MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COO4946NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Counseling PLLC Clinical PastSince May 24, 2011 Accepting new patients
Tidewater Counseling, PLLC Clinical Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1013097898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 OAK DR",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285579634",
            "telephone_number": "252-229-9053",
            "fax_number": "252-648-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PARK AVE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285605502",
            "telephone_number": "252-229-9053",
            "fax_number": "252-648-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "HEATHER",
        "middle_name": "CAMPBELL",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "COO4946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003592",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.