Active NPI
Birchie St. Clair Warren Jr., MA,LPA,HSP-PA
- Clinical Psychologist
- Raleigh, NC
National Provider Identifier
1497897300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1357
- Practice address
- 5300 Pinehall Wynd
Raleigh, NC 27604-5986 - Phone
- (919) 212-3630
- NPI assigned
- Feb 14, 2007
- 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 Psychologist | 103TC0700X | 1357 | NC | Primary |
Addresses
Primary practice location
5300 Pinehall Wynd
Raleigh, NC 27604-5986
Mailing address
5300 Pinehall Wynd
Raleigh, NC 27604-5986
Phone (919) 212-3630
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6107400 | Medicaid | NC | |
| 1357 | Other | NC | NC PSYCHOLOGY LICENSE |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1357 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497897300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 PINEHALL WYND",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276045986",
"telephone_number": "919-212-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 PINEHALL WYND",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276045986",
"telephone_number": "919-212-3630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "BIRCHIE",
"middle_name": "ST. CLAIR",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MA,LPA,HSP-PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1357",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6107400",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC PSYCHOLOGY LICENSE",
"identifier": "1357",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.