Individual provider Active NPI

Heather Ellis Lippincott, MSW, LCSW, LCAS

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1114059110
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007313 Issued in NC
Practice address
5502 Bernhardt CT
Wilmington, NC 28409-3962
Phone
(910) 617-5160
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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 995 NC
Clinical Social Worker 1041C0700X C007313 NC Primary

Addresses

Primary practice location

5502 Bernhardt CT
Wilmington, NC 28409-3962

Mailing address

5502 Bernhardt CT
Wilmington, NC 28409-3962
Phone (910) 617-5160

Other identifiers 1

IdentifierTypeStateIssuer
6111869OtherNCLCAS

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

LicenseStateTypeSpecialty
995NCMDAddiction (Substance Use Disorder) Counselor
C007313NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1114059110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 BERNHARDT CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093962",
            "telephone_number": "910-617-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 BERNHARDT CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093962",
            "telephone_number": "910-617-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPINCOTT",
        "first_name": "HEATHER",
        "middle_name": "ELLIS",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "995",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCAS",
            "identifier": "6111869",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.