Individual provider Active NPI

Jason Macarthur Robichaud, LCSW

  • Clinical Social Worker
  • Candler, NC
National Provider Identifier
1336330018
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005631 Issued in NC
Practice address
69 Wildflower Mountain TRL
Candler, NC 28715-5503
Phone
(828) 242-9531
Fax
(828) 633-0744
NPI assigned
Aug 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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 C005631 NC Primary

Addresses

Primary practice location

69 Wildflower Mountain TRL
Candler, NC 28715-5503

Mailing address

PO Box 1551
Candler, NC 28715-1551
Phone (828) 242-9531

Other identifiers 1

IdentifierTypeStateIssuer
6106827MedicaidNC

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
I20080213000213 NC Practitioner - Clinical Social Worker 3476636572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C005631NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince May 2, 2023 Accepting new patients
Seraphim Children'S Therapy Past Accepting new patients
Seraphim Children'S Therapy Past Accepting new patients

Locations

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

Organizations & group practices 3

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1336330018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1551",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287151551",
            "telephone_number": "828-242-9531",
            "fax_number": "828-633-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 WILDFLOWER MOUNTAIN TRL",
            "city": "CANDLER",
            "state": "NC",
            "postal_code": "287155503",
            "telephone_number": "828-242-9531",
            "fax_number": "828-633-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBICHAUD",
        "first_name": "JASON",
        "middle_name": "MACARTHUR",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106827",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Candler, NC

Sources for this page

Verify at the official NPI Registry.