Individual provider Active NPI

Rosalind Gayla Anderson-Fennell

  • Clinical Social Worker
  • Fuquay Varina, NC
National Provider Identifier
1295501765
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C019490 Issued in NC
Practice address
921 E Broad St # 1028
Fuquay Varina, NC 27526-1960
Phone
(866) 793-3889
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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 C019490 NC Primary

Addresses

Primary practice location

921 E Broad St # 1028
Fuquay Varina, NC 27526-1960

Mailing address

921 E Broad St # 1028
Fuquay Varina, NC 27526-1960
Phone (317) 431-4941

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5750 Johnston St
Suite 205
Lafayette, LA 70503-5300

5750 Johnston St
Suite 205
Lafayette, LA 70503-5345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C019490NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1295501765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E BROAD ST # 1028",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261960",
            "telephone_number": "317-431-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E BROAD ST # 1028",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261960",
            "telephone_number": "866-793-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-FENNELL",
        "first_name": "ROSALIND",
        "middle_name": "GAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C019490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.