Individual provider Active NPI

Elizabeth M Wooten, LCSW

  • Clinical Social Worker
  • Hickory, NC
National Provider Identifier
1154498442
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002589 Issued in NC
Practice address
1985 Tate Blvd SE
Suite 300
Hickory, NC 28602
Phone
(828) 326-5960
Fax
(828) 328-4729
NPI assigned
Nov 29, 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 002589 NC Primary

Addresses

Primary practice location

1985 Tate Blvd SE
Suite 300
Hickory, NC 28602

Mailing address

1985 Tate Blvd SE
Suite 300
Hickory, NC 28602
Phone (828) 326-5960

Other identifiers 1

IdentifierTypeStateIssuer
6003206MedicaidNC

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
002589NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154498442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 TATE BLVD SE",
            "address_2": "SUITE 300",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "28602",
            "telephone_number": "828-326-5960",
            "fax_number": "828-328-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 TATE BLVD SE",
            "address_2": "SUITE 300",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "28602",
            "telephone_number": "828-326-5960",
            "fax_number": "828-328-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "002589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003206",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, 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.