Phallon Dayvault

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P017638 Issued in NC

Practice address

310 Avenue a
New Bern, NC 28560-3220

Phone

(252) 515-4190

NPI assigned

Jun 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Inner Excellence Behavioral Health Services, PLLC

  • Clinical Social Worker
  • New Bern, NC
  • NPI 1275223950
  NPD (past)

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1356070866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 AVENUE A",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285603220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 AVENUE A",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285603220",
            "telephone_number": "252-515-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAYVAULT",
        "first_name": "PHALLON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "freshstartbehavioralhealth@tsecuremail.com",
            "affiliation": "Y",
            "affiliationName": "A Fresh Start Behavioral Health Services, PLLC",
            "address_1": "310 Avenue A",
            "city": "New Bern",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285603220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Lee Davis, MD
• Simone Davis
• Wendy Peek Davis, FNP
• Delaney Dawson
• Lisa Irene Dawson, LCSW
• Martin Crawford De Graw, MD
• Tammie Dean
• Deanna Jo Williamson
• Deanna Jow Williamson
• Steffi Deates

• 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 Jun 9, 2022; 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.