Individual provider Active NPI

Carolyn A. Souders, LCSW

  • Clinical Social Worker
  • Huntersville, NC
National Provider Identifier
1023365756
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017257 Issued in PA
Practice address
13815 Professional Center Dr Ste 100
Huntersville, NC 28078-7951
Phone
(704) 384-1320
Fax
(704) 316-3138
NPI assigned
Aug 13, 2012
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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 CW017257 PA Primary

Addresses

Primary practice location

13815 Professional Center Dr Ste 100
Huntersville, NC 28078-7951

Mailing address

2500 Neshaminy Interplex Dr
Trevose, PA 19053-6943
Phone (267) 991-7666

Other names 1

  • Carolyn A. Kraus Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csouders537419@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409000658 NC Practitioner - Clinical Social Worker 4688937469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4350 Main St
Suite 213
Harrisburg, NC 28075-7448
Phone (267) 253-3063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW017257PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Counseling Services, PLLC Clinical CurrentSince Jun 1, 2021 Accepting new patients

Locations

4350 Main St
Ste 213
Harrisburg, NC 28075
Phone (267) 253-3063

Interoperability endpoints

  • Direct secure messaging: csouders537419@direct.novanthealth.org

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": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1023365756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESHAMINY INTERPLEX DR",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536943",
            "telephone_number": "267-991-7666",
            "fax_number": "267-991-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13815 PROFESSIONAL CENTER DR STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787951",
            "telephone_number": "704-384-1320",
            "fax_number": "704-316-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDERS",
        "first_name": "CAROLYN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csouders537419@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "13815 Professional Center Dr Ste 100",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "KRAUS",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.