Individual provider Active NPI

Robert Jan Hedgepath, LCSW, LCAS, CCS

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1104033406
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1801 Issued in NC
Practice address
4010 Barrett Dr
Suite 101
Raleigh, NC 27609-6622
Phone
(919) 788-8002
Fax
(919) 788-0740
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 098 NC
Clinical Social Worker 1041C0700X 1801 NC Primary

Addresses

Primary practice location

4010 Barrett Dr
Suite 101
Raleigh, NC 27609-6622

Mailing address

4308 New Brighton Dr
Apex, NC 27539-8624
Phone (919) 788-8002

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

LicenseStateTypeSpecialty
098NCMDAddiction (Substance Use Disorder) Counselor
1801NCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104033406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 NEW BRIGHTON DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275398624",
            "telephone_number": "919-788-8002",
            "fax_number": "919-788-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 BARRETT DR",
            "address_2": "SUITE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096622",
            "telephone_number": "919-788-8002",
            "fax_number": "919-788-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDGEPATH",
        "first_name": "ROBERT",
        "middle_name": "JAN",
        "name_prefix": "Mr.",
        "credential": "LCSW, LCAS, CCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "098",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "1801",
            "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 Sep 11, 2025; 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.