Clinical Care Therapy & Wellness, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CLINICAL CARE THERAPY & WELLNESS, PLLC

Practice address

200 Valencia Dr Ste 117
Jacksonville, NC 28546-6312

Phone

(910) 358-6742

NPI assigned

Jul 29, 2024

Last updated

Jan 2, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lavoncia Regan Peterson, LCSW, LCASANPI 1093268146

Title

Ceo/Provider

Phone

(910) 358-6742

Specialties & licenses 2

Addresses

Other names 1

• Clinical Care Therapy & Wellness, Pllc Former legal business name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lavoncia Regan Peterson, LCSW, LCASA

  • Clinical Social Worker
  • Jacksonville, NC
  • NPI 1093268146

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767312000000",
    "number": "1508695586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR STE 117",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466312",
            "telephone_number": "910-358-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR STE 117",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466312",
            "telephone_number": "910-358-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL CARE THERAPY & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-29",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "LAVONCIA",
        "authorized_official_middle_name": "REGAN",
        "authorized_official_title_or_position": "CEO/PROVIDER",
        "authorized_official_telephone_number": "910-358-6742",
        "authorized_official_credential": "LCSW, LCASA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Care Therapy & Wellness, Pllc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.