Individual provider Active NPI

Wivianny De Souza Honeycutt, MSW, LCAS, LCSW

  • Clinical Social Worker
  • Lexington, NC
National Provider Identifier
1336374198
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P005962 Issued in NC
Practice address
820 Grimes Blvd
Lexington, NC 27292-7640
Phone
(336) 224-6071
NPI assigned
May 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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 P005962 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2066 NC

Addresses

Primary practice location

820 Grimes Blvd
Lexington, NC 27292-7640

Mailing address

820 Grimes Blvd
Lexington, NC 27292-7640
Phone (336) 224-6071

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
P005962NCMDClinical Social Worker
2066NCMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1336374198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 GRIMES BLVD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272927640",
            "telephone_number": "336-224-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 GRIMES BLVD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272927640",
            "telephone_number": "336-224-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONEYCUTT",
        "first_name": "WIVIANNY",
        "middle_name": "DE SOUZA",
        "credential": "MSW, LCAS, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P005962",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.