Individual provider Active NPI

Kathleen Corn Parnell, MSW LCSW

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1124121546
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005145 Issued in NC
Practice address
3311 Burnt Mill Dr
Childrens Developmental Services Agency
Wilmington, NC 28403-2654
Phone
(910) 251-5817
Fax
(910) 251-2652
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C005145 NC Primary

Addresses

Primary practice location

3311 Burnt Mill Dr
Childrens Developmental Services Agency
Wilmington, NC 28403-2654

Mailing address

422 Aquarius Dr
Wilmington, NC 28411-9400
Phone (910) 686-6610

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C005145NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124121546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 AQUARIUS DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119400",
            "telephone_number": "910-686-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 BURNT MILL DR",
            "address_2": "CHILDRENS DEVELOPMENTAL SERVICES AGENCY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032654",
            "telephone_number": "910-251-5817",
            "fax_number": "910-251-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARNELL",
        "first_name": "KATHLEEN",
        "middle_name": "CORN",
        "name_prefix": "Mrs.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005145",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.