Individual provider Active NPI

Lynn Evans Piersall

  • Clinical Social Worker
  • Washington, NC
National Provider Identifier
1265978456
Registry record updated Jan 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012107 Issued in NC
Practice address
100 E Main St
Washington, NC 27889-4928
Phone
(252) 940-1611
Fax
(252) 940-1752
NPI assigned
Jan 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2025

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 C012107 NC Primary

Addresses

Primary practice location

100 E Main St
Washington, NC 27889-4928

Mailing address

100 E Main St
Washington, NC 27889-4928
Phone (252) 940-1611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190403000996 NC Practitioner - Clinical Social Worker 3577804426 Reassigns benefits to 2 organizations
I20210721000925 VA Practitioner - Clinical Social Worker 3577804426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pamlico River Behavioral Health, PLLCGroup PAC ID 6608105408, 3 clinicians

Practice addresses (Care Compare)

100 E Main St
Washington, NC 27889-4928
Phone (252) 940-1611

15221 Carrollton Blvd
Suite 207208
Carrollton, VA 23314-2325
Phone (252) 940-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C012107NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Health and Education Partners PLLC CurrentSince Apr 15, 2019 Accepting new patients
Pamlico River Behavioral Health, PLLC Clinical CurrentSince Jun 26, 2019 Accepting new patients

Locations

5306 NC Highway 55
Ste 1
Durham, NC 27713
Phone (919) 457-1517

5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517

100 E Main St
Washington, NC 27889
Phone (252) 940-1611

15221 Carrollton Blvd
Ste 207208
Carrollton, VA 23314
Phone (252) 623-2736

Organizations & group practices 2

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": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735948800000",
    "number": "1265978456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E MAIN ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894928",
            "telephone_number": "252-940-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E MAIN ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278894928",
            "telephone_number": "252-940-1611",
            "fax_number": "252-940-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSALL",
        "first_name": "LYNN",
        "middle_name": "EVANS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2025-01-04",
        "certification_date": "2025-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.