Individual provider Active NPI

Verna Mae Dority, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1508942970
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C002019 Issued in NC
Practice address
1310 Raeford Rd
Suite 2
Fayetteville, NC 28305-5085
Phone
(910) 850-0367
Fax
(910) 485-6572
NPI assigned
Oct 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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 C002019 NC Primary

Addresses

Primary practice location

1310 Raeford Rd
Suite 2
Fayetteville, NC 28305-5085

Mailing address

PO Box 9909
Fayetteville, NC 28311-9094
Phone (910) 850-0367

Other identifiers 2

IdentifierTypeStateIssuer
28942OtherNCBLUE CROSS BLUE SHIELD
6002240MedicaidNC

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
I20040218000046 NC Practitioner - Clinical Social Worker 2769377837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Verna Dority MSW CCSW IncGroup PAC ID 6709070527, 19 clinicians

Practice addresses (Care Compare)

35 Plantation Dr
Suite 100B
Cameron, NC 28326-9430
Phone (919) 895-3222

9909 PO Box
Fayetteville, NC 28311-9094

PO Box
Suite 9909
Fayetteville, NC 28311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C002019NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Verna Dority, MSW, CCSW, Inc Clinical CurrentSince Mar 21, 2009 Accepting new patients

Locations

35 Plantation Dr
Ste 100B
Cameron, NC 28326
Phone (910) 302-6672

1310 Raeford Rd
Ste 2
Fayetteville, NC 28305
Phone (910) 850-0367

602 E Academy St
Ste 103
Fuquay Varina, NC 27526
Phone (910) 762-3185

Interoperability endpoints

  • Direct secure messaging: verna.dority@direct.carolinacounselingservices.nchie.net

Organizations & group practices 1

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": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1508942970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9909",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119094",
            "telephone_number": "910-850-0367",
            "fax_number": "910-485-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 RAEFORD RD",
            "address_2": "SUITE 2",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055085",
            "telephone_number": "910-850-0367",
            "fax_number": "910-485-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORITY",
        "first_name": "VERNA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28942",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002240",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.