Individual provider Active NPI

Martha Sue Quattlebaum, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1255819645
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015041 Issued in NC
Practice address
2501 Bragg Blvd Ste a
Fayetteville, NC 28303-4141
Phone
(910) 460-3392
Fax
(910) 218-9182
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2026

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 C015041 NC Primary

Addresses

Primary practice location

2501 Bragg Blvd Ste a
Fayetteville, NC 28303-4141

Mailing address

PO Box 62
Fayetteville, NC 28302-0062
Phone (910) 460-3392

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
I20220713003920 NC Practitioner - Clinical Social Worker 7416338033 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C015041NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Mental Health & Wellness Solutions, PLLC Clinical Current Accepting new patients
Haymount Institute for Psychological Services, PLLC CurrentSince Jun 30, 2022 Accepting new patients
Haymount Institute for Psychological Services, PLLC Clinical CurrentSince Jun 30, 2022 Accepting new patients

Locations

806 Hay St
Fayetteville, NC 28305
Phone 9108607008117

996 Helen St
Fayetteville, NC 28303
Phone (910) 635-0115

2501 Bragg Blvd
#A
Fayetteville, NC 28303
Phone (910) 946-5676

131 W Edinborough Ave
Raeford, NC 28376
Phone (910) 848-1222

4030 Wake Forest Rd
Ste 349
Raleigh, NC 27609
Phone (336) 280-8301

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1255819645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283020062",
            "telephone_number": "910-460-3392",
            "fax_number": "910-218-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 BRAGG BLVD STE A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034141",
            "telephone_number": "910-460-3392",
            "fax_number": "910-218-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUATTLEBAUM",
        "first_name": "MARTHA",
        "middle_name": "SUE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.