Individual provider Active NPI

Aveary Olivia Walsh, LCSW

  • Clinical Social Worker
  • Conover, NC
National Provider Identifier
1225586555
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012123 Issued in NC
Practice address
873 Northern Dr NW
Conover, NC 28613-6513
Phone
(828) 464-4221
NPI assigned
Sep 15, 2016
Last updated
Aug 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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 C012123 NC Primary
Clinical Social Worker 1041C0700X P010684 NC

Addresses

Primary practice location

873 Northern Dr NW
Conover, NC 28613-6513

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1904

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
I20230321001116 NC Practitioner - Clinical Social Worker 6103290820 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P010684NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc. CurrentSince Mar 7, 2023 Accepting new patients
Gaston Family Health Services, Inc CurrentSince Mar 7, 2023 Accepting new patients
Gaston Family Health Services, Inc. PastSince Aug 28, 2021 Accepting new patients

Locations

873 Northern Dr NW
Conover, NC 28613
Phone (704) 464-4221

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

3050 Riverwood Pkwy
Ste B
Gastonia, NC 28056
Phone (704) 865-1749

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

Interoperability endpoints

  • Direct secure messaging: awalsh356119@direct.ochin.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1225586555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904",
            "fax_number": "704-864-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 NORTHERN DR NW",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286136513",
            "telephone_number": "828-464-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "AVEARY",
        "middle_name": "OLIVIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012123",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conover, NC

Sources for this page

Verify at the official NPI Registry.