Roddy Tate Jr., MSW LCSWA LCASA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P015924 Issued in NC

Practice address

2310 S Miami Blvd
Durham, NC 27703-5798

Phone

(202) 957-8747

NPI assigned

Apr 9, 2021

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: rtate@pwstolife.com

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1164002606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 OFFERRELL STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27405",
            "telephone_number": "202-957-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 S MIAMI BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277035798",
            "telephone_number": "202-957-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "RODDY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW LCSWA LCASA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-16563",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P015924",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RTATE@PWSTOLIFE.COM",
            "affiliation": "N",
            "address_1": "329 OFFERRELL STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carolyn Chyu Tashie, PA-C
• Tiffany A. Taskaya, PA-C
• Brittney Tate
• Emily Marie Tate, CNM
• Rebecca Sue Tate, D.D.S.
• Nerine E. Tatham, M.D.
• Jason Ryan Tatreau, MD
• Lotoya Tatum, RN
• Michael James Tatum, DO
• Jessica Taube

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.