Active NPI
Andrea Wallenbeck
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1346910924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P015277
- Practice address
- 2815 Cates Avenue
Raleigh, NC 27695-0001 - Phone
- (919) 515-2423
- NPI assigned
- Sep 15, 2021
- Last updated
- Sep 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P015277 | NC | Primary |
Addresses
Primary practice location
2815 Cates Avenue
Raleigh, NC 27695-0001
Mailing address
2449 Bertie Dr
Raleigh, NC 27610-1730
Phone (919) 889-3569
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P015277 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Professionals PLLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631664000000",
"number": "1346910924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2449 BERTIE DR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101730",
"telephone_number": "919-889-3569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2815 CATES AVENUE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276950001",
"telephone_number": "919-515-2423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLENBECK",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-15",
"last_updated": "2021-09-15",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P015277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.