Individual provider Active NPI

Marilyn Joan Bara, M.S.W., L.C.S.W.

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1467491902
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C001280 Issued in NC
Practice address
1631 Midtown PL # 104-120
Raleigh, NC 27609-1300
Phone
(919) 971-2282
Fax
(919) 821-1434
NPI assigned
Jun 6, 2006
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 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 C001280 NC Primary

Addresses

Primary practice location

1631 Midtown PL # 104-120
Raleigh, NC 27609-1300

Mailing address

1631 Midtown PL # 104-120
Raleigh, NC 27609-1300
Phone (919) 971-2282

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
I20040714000303 NC Practitioner - Clinical Social Worker 4183603202 Practice locations: Raleigh, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1631 Midtown PL
Raleigh, NC 27609-1300

871 Washington St
Raleigh, NC 27605-1255
Phone (919) 971-2282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C001280NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1467491902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 MIDTOWN PL # 104-120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276091300",
            "telephone_number": "919-971-2282",
            "fax_number": "919-821-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 MIDTOWN PL # 104-120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276091300",
            "telephone_number": "919-971-2282",
            "fax_number": "919-821-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARA",
        "first_name": "MARILYN",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.