Individual provider Active NPI

Georgia Laverne Fesperman, MSW, LCSW

  • Clinical Social Worker
  • Huntersville, NC
National Provider Identifier
1376523852
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C002656 Issued in NC
Practice address
9835 Northcross Center CT
Suite B
Huntersville, NC 28078-7346
Phone
(704) 896-8688
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C002656 NC Primary

Addresses

Primary practice location

9835 Northcross Center CT
Suite B
Huntersville, NC 28078-7346

Mailing address

15206 Waterfront Dr
Huntersville, NC 28078-3250
Phone (704) 947-7497

Other identifiers 1

IdentifierTypeStateIssuer
6106176MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C002656NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Discovery for Kids, Inc. Past Accepting new patients
Move & Grow Inc Past Accepting new patients

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1376523852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15206 WATERFRONT DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783250",
            "telephone_number": "704-947-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9835 NORTHCROSS CENTER CT",
            "address_2": "SUITE B",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787346",
            "telephone_number": "704-896-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FESPERMAN",
        "first_name": "GEORGIA",
        "middle_name": "LAVERNE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106176",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.