Etolia Knight Van Buskirk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009167 Issued in NC

Practice address

1304 Commerce Dr
New Bern, NC 28562-2212

Phone

(252) 637-4673

NPI assigned

Oct 2, 2006

Last updated

Oct 7, 2014By the provider in NPPES

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 names 1

• Etolia Van Buskirk Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Senior Psych Solutions Corp

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1225078629
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1346333499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 LAURA DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285629121",
            "telephone_number": "478-396-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 COMMERCE DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622212",
            "telephone_number": "252-637-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BUSKIRK",
        "first_name": "ETOLIA",
        "middle_name": "KNIGHT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003588",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ETOLIA",
            "last_name": "VAN BUSKIRK",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephonie Nicole Utley, RN
• Jeanne Marie Damore Vacca, FNP-BC
• Veronica Valerio
• Adrianna Vallone, BSN, RN, IBCLC
• Valor Horses for Heroes, PLLC
• John Albert Van Havere, PT, DPT
• Lori Vasquez Van Meir, M.A.
• Harold Mark Vandersea, M.D.
• Erika Vanmeter, M.A. CCC-SLP
• Claire Vargas, PTA

• Clinical Social Worker in New Bern, NC
• Providers in New Bern, 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 Oct 7, 2014; 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.