Heather Fairley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C012161 Issued in NC

Practice address

3000 Highwoods Blvd Ste 310
Raleigh, NC 27604-1029

Phone

(919) 714-7500

NPI assigned

Aug 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heather Streeter Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hope Services, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1083938385
  NPD (past)
• Hope Services, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1134420169
  NPD (past)

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1073069977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28911",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276118911",
            "telephone_number": "984-297-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HIGHWOODS BLVD STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041029",
            "telephone_number": "919-714-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 S Main St",
            "address_purpose": "LOCATION",
            "city": "Louisburg",
            "state": "NC",
            "postal_code": "275492522",
            "country_code": "US",
            "telephone_number": "919-435-8164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRLEY",
        "first_name": "HEATHER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hfairley@hopeservices4u.com",
            "affiliation": "N",
            "address_1": "3000 Highwoods Blvd Ste 310",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276041029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "STREETER",
            "credential": "LCSWA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jaime Carlisle Fair, OTR/L
• Fairchild Holmes Group
• Fairchild Homes
• Amy L Faircloth, PT
• Fairhavens Counseling and Community Services
• Sharon Denice Fairley, MS, LCMHC
• Sydnee Janelle Fairley
• Fairmont Homes LLC
• Arizona Danielle Faison, LICENSE #: 16416
• Crystal Faison

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.

Verify at the official NPI Registry.