Active NPI
Keyanna Ivon Terry, MSW, LCSW-A
- Clinical Social Worker
- Warrenton, NC
National Provider Identifier
1063007011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P015594
- Practice address
- 1932 US Highway 401 S
Warrenton, NC 27589-9631 - Phone
- (877) 589-3969
- Fax
- (877) 786-5369
- NPI assigned
- Mar 2, 2021
- Last updated
- Mar 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P015594 | NC | Primary |
Addresses
Primary practice location
1932 US Highway 401 S
Warrenton, NC 27589-9631
Mailing address
1009 Sandtrap Way
Durham, NC 27703-6581
Phone (919) 824-3330
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | keyanna.terry@coreessentialsnc.org | Direct |
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 |
|---|---|---|---|
| P015594 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Essentials | Clinical | Past | Accepting new patients |
Interoperability endpoints
- keyanna.terry@596425458188292.direct.elationemr.com
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": "1614643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614643200000",
"number": "1063007011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 SANDTRAP WAY",
"city": "DURHAM",
"state": "NC",
"postal_code": "277036581",
"telephone_number": "919-824-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1932 US HIGHWAY 401 S",
"city": "WARRENTON",
"state": "NC",
"postal_code": "275899631",
"telephone_number": "877-589-3969",
"fax_number": "877-786-5369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "KEYANNA",
"middle_name": "IVON",
"credential": "MSW, LCSW-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-02",
"last_updated": "2021-03-02",
"certification_date": "2021-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P015594",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "keyanna.terry@coreessentialsnc.org",
"affiliation": "N",
"endpointDescription": "business email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1932 US Highway 401 S",
"city": "Warrenton",
"state": "NC",
"country_code": "US",
"postal_code": "275899631",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Warrenton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.