Eliezer Vazquez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005393 Issued in NC

Practice address

2809 Highwoods Blvd
Suite 103
Raleigh, NC 27604-1000

Phone

(919) 872-7373

Fax

(919) 872-3713

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Family Services

  • Community/Behavioral Health Agency
  • Clover, SC
  • NPI 1528583879
  Medicare reassignment NPD
• Carolina Community Mental Health Centers, Inc

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1184859761
  NPD (past)
• Real Connections Counseling and Wellness LLC

  • Mental Health Counselor
  • Clover, SC
  • NPI 1447175005
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114077195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT",
            "address_2": "SUITE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041084",
            "telephone_number": "919-872-7373",
            "fax_number": "919-872-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 HIGHWOODS BLVD",
            "address_2": "SUITE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041000",
            "telephone_number": "919-872-7373",
            "fax_number": "919-872-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "ELIEZER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Vaughn
• Bradley K Vaughn, MD
• Chloe Vaughn
• William A Vaughn, LCMHC. LCAS
• Luis Miguel Vazquez-Montesino, MD
• Joshua Manuel Vazquez
• Melissa Vazquez, PA(ASCP)
• Madison Veasey, LPCA, LCAS, NCC
• Vedic Pharmacy LLC
• Vedic Pharmacy LLC

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.