Active NPI
Mary Alta Feddeman, MSW, LCSWA
- Clinical Social Worker
- Durham, NC
National Provider Identifier
1437836558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P019220
- Practice address
- 1735 Guess Rd
Durham, NC 27701-1163 - Phone
- (919) 360-4236
- NPI assigned
- Jun 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P019220 | NC | Primary |
Addresses
Primary practice location
1735 Guess Rd
Durham, NC 27701-1163
Mailing address
1735 Guess Rd
Durham, NC 27701-1163
Phone (919) 360-4236
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
| License | State | Type | Specialty |
|---|---|---|---|
| P019220 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688083200000",
"number": "1437836558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1735 GUESS RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277011163",
"telephone_number": "919-360-4236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1735 GUESS RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277011163",
"telephone_number": "919-360-4236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDDEMAN",
"first_name": "MARY",
"middle_name": "ALTA",
"credential": "MSW, LCSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-30",
"last_updated": "2023-06-30",
"certification_date": "2023-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P019220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.