Raleigh Psychotherapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005387 Issued in NC

Legal business name

RALEIGH PSYCHOTHERAPY, PLLC

Practice address

4016 Barrett Drive
Suite 104
Raleigh, NC 27609

Phone

(919) 824-9102

Fax

(919) 824-9102

NPI assigned

Feb 2, 2015

Last updated

Jul 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Beverly M Simmons, PHD, LCSWNPI 1942311626

Title

Clinical Social Worker/Owner

Phone

(919) 824-9102

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Beverly M Simmons, LCSW

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1942311626
  Authorized official Same address or phone

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1205226909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 BARRETT DRIVE",
            "address_2": "SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-824-9102",
            "fax_number": "919-883-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 BARRETT DRIVE",
            "address_2": "SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-824-9102",
            "fax_number": "919-824-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER/OWNER",
        "authorized_official_telephone_number": "919-824-9102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, 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 Jul 14, 2023; 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.