Individual provider Active NPI

Alexandra Judith Lagunas, LCSW

  • Clinical Social Worker
  • Waxhaw, NC
National Provider Identifier
1215459524
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013554 Issued in NC
Practice address
9929 Rea Rd Ste 201
Waxhaw, NC 28173-6439
Phone
(704) 316-1650
Fax
(704) 316-1651
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C013554 NC Primary
Mental Health Counselor 101YM0800X L252-0109-2783 IL

Addresses

Primary practice location

9929 Rea Rd Ste 201
Waxhaw, NC 28173-6439

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

6824 Harrisburg Rd
Charlotte, NC 28227-3389
Phone (000) 000-0000

Other identifiers 1

IdentifierTypeStateIssuer
ROF801112066OtherILBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220831003577 NC Practitioner - Clinical Social Worker 0244614790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

3625 N Elm St
Suite 130
Greensboro, NC 27455-2604
Phone (704) 360-3637

855 Sam Newell Rd
Suite 100
Matthews, NC 28105-7593
Phone (704) 360-3637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L252-0109-2783ILMDMental Health Counselor
C013554NCMDClinical Social Worker

Organizations & group practices 1

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1215459524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9929 REA RD STE 201",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736439",
            "telephone_number": "704-316-1650",
            "fax_number": "704-316-1651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6824 Harrisburg Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282273389",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAGUNAS",
        "first_name": "ALEXANDRA",
        "middle_name": "JUDITH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013554",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "L252-0109-2783",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "ROF801112066",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

Verify at the official NPI Registry.