Individual provider Active NPI

Keishona Farmer, LCSW-A

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1396355111
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P014517 Issued in NC
Practice address
324 Person St
Fayetteville, NC 28301-5736
Phone
(910) 438-0939
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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 P014517 NC Primary

Addresses

Primary practice location

324 Person St
Fayetteville, NC 28301-5736

Mailing address

2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112002282 NC Practitioner - Clinical Social Worker 7113451287 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P014517NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Beauty in Healing Therapy and Wellness PLLC Clinical Current Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Sep 11, 2024 Accepting new patients
Thriving Lane CurrentSince Apr 2, 2025 Accepting new patients
Carolina Outreach, LLC PastSince Aug 9, 2020 Accepting new patients
Perspectives LTD Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

808 Hope Mills Rd
Fayetteville, NC 28304
Phone (910) 407-3455

4801 Glenwood Ave
Ste 200
Raleigh, NC 27612
Phone (757) 866-2715

Organizations & group practices 5

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": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1396355111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 DURHAM CHAPEL HILL BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 PERSON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015736",
            "telephone_number": "910-438-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "KEISHONA",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.