Individual provider Active NPI

Bernadette Cooper Vereen, LCSWA

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1285390237
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P016259 Issued in NC
Practice address
2608 Erwin Rd Ste 300
Durham, NC 27705-4597
Phone
(919) 660-6398
Fax
(919) 681-1600
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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 P016259 NC Primary

Addresses

Primary practice location

2608 Erwin Rd Ste 300
Durham, NC 27705-4597

Mailing address

2608 Erwin Rd Ste 300
Durham, NC 27705-4597
Phone (919) 660-6398

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P016259NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1285390237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 ERWIN RD STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054597",
            "telephone_number": "919-660-6398",
            "fax_number": "919-681-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 ERWIN RD STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054597",
            "telephone_number": "919-660-6398",
            "fax_number": "919-681-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEREEN",
        "first_name": "BERNADETTE",
        "middle_name": "COOPER",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016259",
            "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 Nov 15, 2021; 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.