Active NPI
Maggie Marie Dicesare, COTA/L
- Occupational Therapy Assistant
- Raleigh, NC
National Provider Identifier
1053923896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 12401
- Practice address
- 4801 Edwards Mill Rd
Raleigh, NC 27612-4417 - Phone
- (919) 787-0777
- NPI assigned
- Aug 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 12401 | NC | Primary |
Addresses
Primary practice location
4801 Edwards Mill Rd
Raleigh, NC 27612-4417
Mailing address
6193 NC Highway 102 W
Chocowinity, NC 27817-9108
Phone (252) 531-5190
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12401 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598054400000",
"number": "1053923896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6193 NC HIGHWAY 102 W",
"city": "CHOCOWINITY",
"state": "NC",
"postal_code": "278179108",
"telephone_number": "252-531-5190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 EDWARDS MILL RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276124417",
"telephone_number": "919-787-0777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICESARE",
"first_name": "MAGGIE",
"middle_name": "MARIE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-22",
"last_updated": "2020-08-22",
"certification_date": "2020-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "12401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.