Obsidian Care Collective PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

OBSIDIAN CARE COLLECTIVE PLLC

Practice address

100 N Churton St Ste 206
Hillsborough, NC 27278-2534

Phone

(410) 292-2847

NPI assigned

Nov 7, 2021

Organization subpart

No

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

Authorized official

Name

Jacqueline Newton, LCSWNPI 1871881847

Title

Owner

Phone

(828) 273-8422

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Louise Newton, MSW, LCSW

  • Clinical Social Worker
  • Hillsborough, NC
  • NPI 1871881847
  NPD Authorized official
• Mary Kelly Gomeringer, LCSW

  • Clinical Social Worker
  • Durham, NC
  • NPI 1619263167
  NPD

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

{
    "created_epoch": "1636243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636761600000",
    "number": "1336804095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N CHURTON ST STE 206",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272782534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N CHURTON ST STE 206",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272782534",
            "telephone_number": "410-292-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSIDIAN CARE COLLECTIVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-07",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-273-8422",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hillsborough, NC
• Providers in Hillsborough, 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 Nov 13, 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.