Lavenda T Rogers, MSW, ,LCSWA ,LLMSW

Individual provider Active NPI Clinical Social Worker · Clarkton, NC

NPI 1497399513 · NPPES record last updated Feb 7, 2024

Key facts

NPI
1497399513
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6851115271 (MI)
Practice address
142 Rehobeth Church Rd
Clarkton, NC 28433-8014
Phone
(910) 801-4567
NPI assigned
Oct 31, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240911002052 NC Practitioner - Clinical Social Worker 6608316195 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6851115271MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Start Counseling Services,LLC Clinical Current
since Dec 3, 2023
Accepting new patients
Brightside Counseling Services, PLLC Clinical Current
since Apr 1, 2024
Accepting new patients

Locations

110 Memory Plz
#107
Whiteville, NC 28472

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851115271 MI Yes
Clinical Social Worker 1041C0700X P018294 NC

Addresses

Primary practice location

142 Rehobeth Church Rd
Clarkton, NC 28433-8014

Mailing address

142 Rehobeth Church Rd
Clarkton, NC 28433-8014
Phone (910) 801-4567

Other practice location 1

142 Rehobeth Church Rd
Clarkton, NC 28433-8014
Phone (910) 801-4567

Other identifiers

IdentifierTypeStateIssuer
1025MedicaidNJ

Other providers in Clarkton, NC

All providers in Clarkton, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.