Individual provider Active NPI

Heather Marie Rubino, LCSW

  • Clinical Social Worker
  • Shallotte, NC
National Provider Identifier
1114589504
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C014748 Issued in NC
Practice address
120 Coastal Horizons Dr
Shallotte, NC 28470-6094
Phone
(910) 754-4515
Fax
(910) 202-9966
NPI assigned
Jul 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P013830 NC
Clinical Social Worker 1041C0700X C014748 NC Primary

Addresses

Primary practice location

120 Coastal Horizons Dr
Shallotte, NC 28470-6094

Mailing address

615 Shipyard Blvd
Wilmington, NC 28412-6431

Other practice location 1

8128 River Rd SE
Southport, NC 28461-8972
Phone (910) 377-1794

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
I20220316001226 NC Practitioner - Clinical Social Worker 2860887585 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Horizons Center, Inc.Group PAC ID 9739267964, 50 clinicians

Practice addresses (Care Compare)

10239 Beach Dr SW
Suite 21
Calabash, NC 28467-2703
Phone (910) 377-1794

120 Coastal Horizons Dr
Shallotte, NC 28470-6094
Phone (910) 343-0145

PO Box
Suite 6741
Ocean Isle Beach, NC 28469-0741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P013830NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Desired Changes, PLLC Clinical CurrentSince Apr 12, 2024 Accepting new patients
Coastal Horizons Center Inc CurrentSince Mar 8, 2022 Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients
Coastal Horizons Center, Inc. Current Accepting new patients
Coastal Horizons Center Inc CurrentSince Mar 8, 2022 Accepting new patients

Locations

10239 Beach Dr SW
Ste 21
Calabash, NC 28467
Phone (910) 377-1794

120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515

8128 River Rd SE
Southport, NC 28461
Phone (910) 367-5036

615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709

Organizations & group practices 5

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": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1114589504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 COASTAL HORIZONS DR",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284706094",
            "telephone_number": "910-754-4515",
            "fax_number": "910-202-9966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8128 River Rd SE",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "NC",
            "postal_code": "284618972",
            "country_code": "US",
            "telephone_number": "910-377-1794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013830",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.