Active NPI
Clark C. Corwin, LCSW
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1104845379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C003338
- Practice address
- 4208 Six Forks Rd
BLDG 1, Suite 305 a
Raleigh, NC 27609-5735 - Phone
- (800) 632-6074
- Fax
- (866) 341-7512
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 | C003338 | NC | Primary |
Addresses
Primary practice location
4208 Six Forks Rd
BLDG 1, Suite 305 a
Raleigh, NC 27609-5735
Mailing address
PO Box 123
Cullowhee, NC 28723-0123
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6003459 | Medicaid | NC | |
| 135P9 | Other | NC | BCBS NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C003338 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cullowhee Community Counseling | Clinical | Current | Accepting new patients |
| Paradigm Health Services, Inc | Clinical | Past | Accepting new patients |
| Smoky Mountain Center for MH/DD/Sas | Past | Accepting new patients | |
| Paradigm Health, LLC | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Clinical Social Worker
- Cullowhee, NC
- NPI 1265161327
-
- Psychiatry Physician
- Waynesville, NC
- NPI 1346388782
-
- Mental Health Counselor
- Clearwater, FL
- NPI 1942245568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352764800000",
"number": "1104845379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 123",
"city": "CULLOWHEE",
"state": "NC",
"postal_code": "287230123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4208 SIX FORKS RD",
"address_2": "BLDG 1, SUITE 305 A",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276095735",
"telephone_number": "800-632-6074",
"fax_number": "866-341-7512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORWIN",
"first_name": "CLARK",
"middle_name": "C.",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2012-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C003338",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6003459",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "135P9",
"state": "NC"
}
],
"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 Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.