Adam Michael Carlson, MSW, LCSW-A, LCAS-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C014117 Issued in NC

Practice address

4054 S Memorial Dr Ste K
Winterville, NC 28590-8690

Phone

(252) 561-8112

Fax

(252) 561-7455

NPI assigned

Aug 2, 2019

Last updated

Oct 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1366097883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 COMMERCE ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585029",
            "telephone_number": "252-321-8080",
            "fax_number": "252-321-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 S MEMORIAL DR STE K",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285908690",
            "telephone_number": "252-561-8112",
            "fax_number": "252-561-7455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Commerce St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278585029",
            "country_code": "US",
            "telephone_number": "252-321-8080",
            "fax_number": "252-321-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "credential": "MSW, LCSW-A, LCAS-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-02",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-25691",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Winterville",
            "affiliation": "N",
            "endpointDescription": "Therap and organizational files",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4054 S Memorial Dr Ste K",
            "city": "Winterville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285908690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Winterville, NC
• Providers in Winterville, 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 22, 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.