Charles Lavie Deville Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1203-C Issued in AR

Practice address

2200 Fort Roots Dr
Mental Health Service (116/NLR)
North Little Rock, AR 72114-1709

Phone

(501) 257-3190

Fax

(501) 257-3180

NPI assigned

Jan 10, 2013

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 AR

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

Specialty

Clinical Social Worker

Education

University of Tennessee, HSC, College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverstone Wellness Center, PLLCGroup PAC ID 9133538275, 7 clinicians

Practice addresses (Care Compare)

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.

• Riverstone Wellness Center, PLLC

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1265897946
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1114264298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 FORT ROOTS DR",
            "address_2": "MENTAL HEALTH SERVICE (116/NLR)",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721141709",
            "telephone_number": "501-257-3190",
            "fax_number": "501-257-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORT ROOTS DR",
            "address_2": "MENTAL HEALTH SERVICE (116/NLR)",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721141709",
            "telephone_number": "501-257-3190",
            "fax_number": "501-257-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVILLE",
        "first_name": "CHARLES",
        "middle_name": "LAVIE",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-10",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1203-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermlogic, P.L.L.C, PA
• Lauren Derr
• Freya Desai
• Robert Matthew Desalvo
• Rajani Deshagoni, MBBS
• Allison Nicole Dewalt, LCSW
• Cassondra Dawn Deweese, BSE
• Karanbir S Dhillon, MD
• Diagnostic Physicians of Arkansas, PA
• Dialysis Centers of Arkansas, PA

• Clinical Social Worker in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.