Individual provider Active NPI

Paul S Jones, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1396305629
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011878 Issued in NC
Practice address
1381 Walter Reed Rd # 419
Fayetteville, NC 28304-4415
Phone
(109) 106-7031
NPI assigned
Jun 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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 C011878 NC Primary

Addresses

Primary practice location

1381 Walter Reed Rd # 419
Fayetteville, NC 28304-4415

Mailing address

1381 Walter Reed Rd # 419
Fayetteville, NC 28304-4415
Phone (109) 106-7031

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
C011878NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1396305629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 WALTER REED RD # 419",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044415",
            "telephone_number": "109-106-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 WALTER REED RD # 419",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044415",
            "telephone_number": "109-106-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.