Individual provider Active NPI

Nancy Carlson, MSW, LICSW

  • Social Worker
  • Beckley, WV
National Provider Identifier
1124361407
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
BP00944135 Issued in WV
Practice address
120 Harper CT
Beckley, WV 25801-2650
Phone
(304) 255-7526
Fax
(304) 252-2329
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X BP00944135 WV Primary

Addresses

Primary practice location

120 Harper CT
Beckley, WV 25801-2650

Mailing address

PO Box 5084
Beckley, WV 25801-7500
Phone (304) 255-7526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20150629002028 WV Practitioner - Clinical Social Worker 6103138482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Life Strategies Counseling Services IncGroup PAC ID 6002819687, 10 clinicians

Practice addresses (Care Compare)

25 Mallard CT
Beckley, WV 25801-3664
Phone (304) 255-7526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BP00944135WVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Strategies Counseling Services Inc. CurrentSince Apr 4, 2015 Accepting new patients
Beautiful Minds Counseling Center Past Accepting new patients

Locations

120 Harper Ct
Beckley, WV 25801
Phone (304) 255-7526

25 Mallard Ct
Beckley, WV 25801
Phone (304) 255-2527

Organizations & group practices 2

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1124361407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5084",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258017500",
            "telephone_number": "304-255-7526",
            "fax_number": "304-252-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HARPER CT",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012650",
            "telephone_number": "304-255-7526",
            "fax_number": "304-252-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "NANCY",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00944135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.