Individual provider Active NPI

Elizabeth R Patrick, LCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1275077216
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013017 Issued in NC
Practice address
207 W Millbrook Rd Ste 210
Raleigh, NC 27609-4490
Phone
(919) 505-1133
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 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 C013017 NC Primary

Addresses

Primary practice location

207 W Millbrook Rd Ste 210
Raleigh, NC 27609-4490

Mailing address

207 W Millbrook Rd Ste 210 #2014
Raleigh, NC 27609-4490
Phone (919) 505-1133

Other practice location 1

2634 Durham Chapel Hill Blvd Ste 209
Durham, NC 27707-2877
Phone (919) 900-7438

Other practice location 2

8376 Six Forks Rd Ste 104
Raleigh, NC 27615-5095
Phone (919) 900-7438

Other practice location 3

1300 Rushing Creek Pkwy
Raleigh, NC 27610-4699
Phone (919) 505-1133

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
C013017NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fernandez Community Center, LLC CurrentSince Apr 1, 2020 Accepting new patients

Locations

8376 Six Forks Rd
Ste 104
Raleigh, NC 27615
Phone (919) 585-5085

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1275077216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W MILLBROOK RD STE 210 #2014",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094490",
            "telephone_number": "919-505-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W MILLBROOK RD STE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094490",
            "telephone_number": "919-505-1133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2634 Durham Chapel Hill Blvd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277072877",
            "country_code": "US",
            "telephone_number": "919-900-7438",
            "fax_number": "919-900-7576",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8376 Six Forks Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276155095",
            "country_code": "US",
            "telephone_number": "919-900-7438",
            "fax_number": "919-900-7576",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Rushing Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276104699",
            "country_code": "US",
            "telephone_number": "919-505-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.