Individual provider Active NPI

Jacob Douglas Lawrence, LCSW

  • Clinical Social Worker
  • Candler, NC
National Provider Identifier
1104370048
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
19 Eplee LN
Candler, NC 28715-6403
Phone
(828) 458-9445
Fax
(828) 641-9272
NPI assigned
Aug 9, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 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 22857 NC
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

19 Eplee LN
Candler, NC 28715-6403

Mailing address

19 Eplee LN
Candler, NC 28715-6403
Phone (828) 458-9445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109001531 NC Practitioner - Clinical Social Worker 4486990603 Reassigns benefits to 1 organization
Practice locations: Candler, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19 Eplee LN
Candler, NC 28715-6403
Phone (828) 458-9445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22857NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob Lawrence LCSW Lcas PLLC Addiction (Substance Use Disorder) CurrentSince May 10, 2025 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1104370048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 EPLEE LN",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287156403",
            "telephone_number": "828-458-9445",
            "fax_number": "828-641-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 EPLEE LN",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287156403",
            "telephone_number": "828-458-9445",
            "fax_number": "828-641-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JACOB",
        "middle_name": "DOUGLAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "22857",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Candler, NC

Sources for this page

Verify at the official NPI Registry.