Individual provider Active NPI

Jonadab Samuel Franco, PSYD, LCSW, LISW-CP

  • Clinical Social Worker
  • Rockingham, NC
National Provider Identifier
1275853103
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004437 Issued in NC
Practice address
304 E Green St
Rockingham, NC 28379-3423
Phone
(910) 817-9181
Fax
(800) 878-9353
NPI assigned
Jun 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7329 SC
Clinical Social Worker 1041C0700X C004437 NC Primary

Addresses

Primary practice location

304 E Green St
Rockingham, NC 28379-3423

Mailing address

304 E Green St
Rockingham, NC 28379-3423
Phone (910) 817-9181

Other identifiers 2

IdentifierTypeStateIssuer
SW1383MedicaidSC
00168663MedicaidNC

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
I20100602000823 NC Practitioner - Clinical Social Worker 0042349920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
21St Century Counseling, PLLC 2 clinicians

Practice addresses (Care Compare)

304 E Green St
Rockingham, NC 28379-3423
Phone (910) 817-9181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7329SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
21St Century Counseling, PLLC Clinical CurrentSince Aug 15, 2017 Accepting new patients

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": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1275853103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E GREEN ST",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793423",
            "telephone_number": "910-817-9181",
            "fax_number": "800-878-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 E GREEN ST",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793423",
            "telephone_number": "910-817-9181",
            "fax_number": "800-878-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCO",
        "first_name": "JONADAB",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PSYD, LCSW, LISW-CP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "7329",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1383",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00168663",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, NC

Sources for this page

Verify at the official NPI Registry.