Individual provider Active NPI

Gladys Adjei Takyi, MSW, LCSWA, LCAS

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1518680313
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PO17862 Issued in NC
Practice address
2565 Ravenhill Dr Ste 2C
Fayetteville, NC 28303-5414
Phone
(910) 864-1799
Fax
(910) 864-9016
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 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 WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X PO17862 NC Primary

Addresses

Primary practice location

2565 Ravenhill Dr Ste 2C
Fayetteville, NC 28303-5414

Mailing address

805 Ronald Reagan Dr
Fayetteville, NC 28311-1678
Phone (910) 228-9778

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

State licenses

LicenseStateTypeSpecialty
PO17862NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United Transit Services CurrentSince May 26, 2024 Accepting new patients

Locations

2565 Ravenhill Dr
Ste 2C
Fayetteville, NC 28303
Phone (910) 864-1799

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": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1518680313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 RONALD REAGAN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111678",
            "telephone_number": "910-228-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 RAVENHILL DR STE 2C",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035414",
            "telephone_number": "910-864-1799",
            "fax_number": "910-864-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKYI",
        "first_name": "GLADYS",
        "middle_name": "ADJEI",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSWA, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "PO17862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.