Elizabeth Detweiler, LCAS, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C006918 Issued in NC

Practice address

839 Wake Forest Business Park Ste C
Wake Forest, NC 27587-7335

Phone

(919) 622-5776

NPI assigned

Jan 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281830400000",
    "number": "1306992193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1171",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275881171",
            "telephone_number": "919-622-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 WAKE FOREST BUSINESS PARK STE C",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877335",
            "telephone_number": "919-622-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWEILER",
        "first_name": "ELIZABETH",
        "credential": "LCAS, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006918",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1413",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112148",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Anne Delarosa, NP
• Bethany Chyanne Dement, LCMHCA
• Breanna Dent, DNP, PMHNP-BC, RN
• James Derse, LCMHCA
• Joanna R Desupinski
• Susan L Deverna, RPH.
• Ruth Devito, M.A
• Candida Devivo, LMBT
• Misty Cable Deyo, MS, CCC-SLP
• Erin Laura Diamond-Paulsen, FNP

• Clinical Social Worker in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.