Individual provider Active NPI

Dellave Brown, LCSW-A

  • Clinical Social Worker
  • Winston Salem, NC
National Provider Identifier
1497025167
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P007595 Issued in NC
Practice address
3720 Vest Mill Rd
Winston Salem, NC 27103-2912
Phone
(336) 659-6135
Fax
(336) 659-6184
NPI assigned
Jan 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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 P007595 NC Primary

Addresses

Primary practice location

3720 Vest Mill Rd
Winston Salem, NC 27103-2912

Mailing address

3720 Vest Mill Rd
Winston Salem, NC 27103-2912
Phone (336) 659-6135

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
P007595NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1497025167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 VEST MILL RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032912",
            "telephone_number": "336-659-6135",
            "fax_number": "336-659-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 VEST MILL RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032912",
            "telephone_number": "336-659-6135",
            "fax_number": "336-659-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DELLAVE",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P007595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.