Individual provider Active NPI

Andrea Leigh Hayward, LCSW

  • Clinical Social Worker
  • Cornelius, NC
National Provider Identifier
1417298449
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009419 Issued in NC
Practice address
17105 Kenton Dr
Suite 205C
Cornelius, NC 28031-5653
Phone
(704) 727-6297
NPI assigned
Mar 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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 C009419 NC Primary

Addresses

Primary practice location

17105 Kenton Dr
Suite 205C
Cornelius, NC 28031-5653

Mailing address

17105 Kenton Dr
Suite 205C
Cornelius, NC 28031-5653
Phone (704) 727-6297

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
I20170301000833 NC Practitioner - Clinical Social Worker 3870877376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17105 Kenton Dr
Suite 200C
Cornelius, NC 28031-5654
Phone (980) 434-6715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C009419NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Newlife Counseling and Consultation, PLLC Clinical CurrentSince Jul 1, 2016 Accepting new patients

Locations

17105 Kenton Dr
Ste 205C
Cornelius, NC 28031
Phone (704) 380-0106

17105 Kenton Dr
Ste 200C
Cornelius, NC 28031
Phone (704) 997-8698

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1417298449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17105 KENTON DR",
            "address_2": "SUITE 205C",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315653",
            "telephone_number": "704-727-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17105 KENTON DR",
            "address_2": "SUITE 205C",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315653",
            "telephone_number": "704-727-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWARD",
        "first_name": "ANDREA",
        "middle_name": "LEIGH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

Verify at the official NPI Registry.