Individual provider Active NPI

Carol C. Bennett, LCSW

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1073189189
Registry record updated May 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004509 Issued in NC
Practice address
407 Foxwood LN
Wilmington, NC 28409-3996
Phone
(910) 612-4985
NPI assigned
May 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2021

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 C004509 NC Primary

Addresses

Primary practice location

407 Foxwood LN
Wilmington, NC 28409-3996

Mailing address

407 Foxwood LN
Wilmington, NC 28409-3996
Phone (910) 612-4985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C004509NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1622246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622246400000",
    "number": "1073189189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 FOXWOOD LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093996",
            "telephone_number": "910-612-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 FOXWOOD LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093996",
            "telephone_number": "910-612-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "CAROL",
        "middle_name": "C.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-29",
        "last_updated": "2021-05-29",
        "certification_date": "2021-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.