Active NPI
Nina Difederico
- Clinical Social Worker
- New Bern, NC
National Provider Identifier
1265135271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 2407 Grace Ave
New Bern, NC 28562-4416 - Phone
- (315) 730-1923
- NPI assigned
- Mar 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
2407 Grace Ave
New Bern, NC 28562-4416
Mailing address
1313 Comet Dr
New Bern, NC 28562-1107
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240628003059 | NC | Practitioner - Clinical Social Worker | 0042754293 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Fresh Start Behavioral Health Services, PLLC | Clinical | Current | Accepting new patients |
| Butterfly Wishes Therapy PLLC | Clinical | Current | Accepting new patients |
| Imperial Counseling & Coaching Services, LLC | Clinical | Past | Accepting new patients |
Locations
2407 Grace Ave
Trent Woods, NC 28562
Phone (252) 514-7766
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.
-
- Clinical Social Worker
- New Bern, NC
- NPI 1710499223
Clinical, NC
-
- Clinical Social Worker
- 27834, NC
- NPI 1952110561
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1265135271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1313 COMET DR",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285621107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2407 GRACE AVE",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285624416",
"telephone_number": "315-730-1923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFEDERICO",
"first_name": "NINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bern, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.