Individual provider Active NPI

Sean Ryan Estes, MSW, LCAS

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1043513286
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P005525 Issued in NC
Practice address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone
(910) 202-5709
NPI assigned
Dec 9, 2010
Last updated
Oct 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1743 NC
Clinical Social Worker 1041C0700X P005525 NC Primary

Addresses

Primary practice location

615 Shipyard Blvd
Wilmington, NC 28412-6431

Mailing address

715 N 4TH St
Unit 301
Wilmington, NC 28401-3459
Phone (336) 926-2896

Other practice location 1

715 N 4th St
Unit 301
Wilmington, NC 28401-3459
Phone (336) 926-2896

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
1743NCMDAddiction (Substance Use Disorder) Counselor
P005525NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1043513286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N 4TH ST",
            "address_2": "UNIT 301",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013459",
            "telephone_number": "336-926-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-202-5709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 N 4th St",
            "address_2": "Unit 301",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284013459",
            "country_code": "US",
            "telephone_number": "336-926-2896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTES",
        "first_name": "SEAN",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "MSW, LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-09",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1743",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P005525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.