Individual provider Active NPI

Raitesha Neville, LCSW

  • Clinical Social Worker
  • Rocky Mount, NC
National Provider Identifier
1407313752
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P013224 Issued in NC
Practice address
518 Arlington St
Rocky Mount, NC 27801-5657
Phone
(252) 567-8619
NPI assigned
Feb 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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 P013224 NC Primary

Addresses

Primary practice location

518 Arlington St
Rocky Mount, NC 27801-5657

Mailing address

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone (252) 266-0128

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
P013224NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1407313752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 CURTIS ELLIS DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042237",
            "telephone_number": "252-266-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 ARLINGTON ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278015657",
            "telephone_number": "252-567-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "RAITESHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.