Individual provider Active NPI

Ladawn Bridges, MSW, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1508154196
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009091 Issued in NC
Practice address
58 Celtic Dr
Durham, NC 27703-2894
Phone
(919) 797-8419
NPI assigned
Jul 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 C009091 NC Primary

Addresses

Primary practice location

58 Celtic Dr
Durham, NC 27703-2894

Mailing address

58 Celtic Dr
Durham, NC 27703-2894
Phone (919) 792-8355

Other practice location 1

1536 N Jefferson St
Jacksonville, FL 32209-6525
Phone (904) 732-6300

Other practice location 2

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

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
I20160202001248 NC Practitioner - Clinical Social Worker 9032413646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C009091NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina Clinical CurrentSince Feb 1, 2025 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Feb 1, 2025 Accepting new patients

Locations

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

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.

NPI Registry JSON

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

{
    "created_epoch": "1310774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1508154196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 CELTIC DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032894",
            "telephone_number": "919-792-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CELTIC DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032894",
            "telephone_number": "919-797-8419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1536 N Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096525",
            "country_code": "US",
            "telephone_number": "904-732-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "LADAWN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-16",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.