Active NPI
Lanier Derbyshire
- Clinical Social Worker
- Cary, NC
National Provider Identifier
1487497947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P020636
- Practice address
- 101 SW Cary Pkwy Ste 40
Cary, NC 27511-5562 - Phone
- (919) 858-6910
- NPI assigned
- Jun 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | P020636 | NC | Primary |
Addresses
Primary practice location
101 SW Cary Pkwy Ste 40
Cary, NC 27511-5562
Mailing address
702 Glascock St
Raleigh, NC 27604-2350
Phone (919) 995-1509
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 |
|---|---|---|---|
| P020636 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1487497947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 GLASCOCK ST",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276042350",
"telephone_number": "919-995-1509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SW CARY PKWY STE 40",
"city": "CARY",
"state": "NC",
"postal_code": "275115562",
"telephone_number": "919-858-6910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERBYSHIRE",
"first_name": "LANIER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-13",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P020636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.