Individual provider Active NPI

Deborah Kaye Rich, LCSW LPC MAC

  • Clinical Social Worker
  • Southern Pines, NC
National Provider Identifier
1235124090
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C001987 Issued in NC
Practice address
185 E New Hampshire Ave
Southern Pines, NC 28387-5529
Phone
(910) 692-9100
Fax
(910) 692-9109
NPI assigned
Sep 16, 2005
Last updated
Jan 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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 C001987 NC Primary

Addresses

Primary practice location

185 E New Hampshire Ave
Southern Pines, NC 28387-5529

Mailing address

185 E New Hampshire Ave
Southern Pines, NC 28387-5529
Phone (910) 692-9100

Other identifiers 1

IdentifierTypeStateIssuer
6002147MedicaidNC

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
I20040917000971 NC Practitioner - Clinical Social Worker 8628046653 Practice locations: Southern Pines, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Brody School of Medicine at East Carolina University, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1100 E Connecticut Ave
Southern Pines, NC 28387-6719
Phone (910) 692-9100

185 E New Hampshire Ave
Southern Pines, NC 28387-6719
Phone (910) 692-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C001987NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore W. Lane PHD, PLLC Past Accepting new patients

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, 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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1235124090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 E NEW HAMPSHIRE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875529",
            "telephone_number": "910-692-9100",
            "fax_number": "910-692-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 E NEW HAMPSHIRE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875529",
            "telephone_number": "910-692-9100",
            "fax_number": "910-692-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "DEBORAH",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "LCSW LPC MAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002147",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

Verify at the official NPI Registry.