Individual provider Active NPI

Katiesha Louella Hayes-Jones, LCSWA

  • Clinical Social Worker
  • Whiteville, NC
National Provider Identifier
1376207209
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P017069 Issued in NC
Practice address
732 Davis Ave
Whiteville, NC 28472-6002
Phone
(910) 640-1038
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P017069 NC Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-27578 NC

Addresses

Primary practice location

732 Davis Ave
Whiteville, NC 28472-6002

Mailing address

732 Davis Ave
Whiteville, NC 28472-6002
Phone (910) 640-1038

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

LicenseStateTypeSpecialty
LCAS-27578NCMDAddiction (Substance Use Disorder) Counselor
P017069NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Healthcare Inc. CurrentSince Oct 17, 2006 Accepting new patients
Advantage Behavioral Healthcare Inc. Addiction (Substance Use Disorder) PastSince Oct 31, 2021 Accepting new patients

Locations

1600 E 5th St
Lumberton, NC 28358
Phone (910) 640-1038

609 Harry West Ln
Pembroke, NC 28372
Phone (910) 521-7288

732 Davis Ave
Whiteville, NC 28472
Phone (910) 632-4633

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1376207209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 DAVIS AVE",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284726002",
            "telephone_number": "910-640-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 DAVIS AVE",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284726002",
            "telephone_number": "910-640-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES-JONES",
        "first_name": "KATIESHA",
        "middle_name": "LOUELLA",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017069",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-27578",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.