Individual provider Active NPI

Mary Whalen, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1275044828
Registry record updated Oct 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C002705 Issued in NC
Practice address
2741 Campus Walk Ave Building 400
Suite 100
Durham, NC 27705-8878
Phone
(984) 888-5876
NPI assigned
Oct 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2017

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 C002705 NC Primary

Addresses

Primary practice location

2741 Campus Walk Ave Building 400
Suite 100
Durham, NC 27705-8878

Mailing address

22 Cedar Hill Dr
Durham, NC 27713-9382
Phone (919) 599-3296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C002705NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1508630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508630400000",
    "number": "1275044828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CEDAR HILL DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139382",
            "telephone_number": "19195993296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 CAMPUS WALK AVE BUILDING 400",
            "address_2": "SUITE 100",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277058878",
            "telephone_number": "984-888-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-22",
        "last_updated": "2017-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.