Individual provider Active NPI

Stephonie Deonne Coward-Leary, LCSWA

  • Clinical Social Worker
  • New Bern, NC
National Provider Identifier
1558041756
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P019450 Issued in NC
Practice address
1425 S Glenburnie Rd Ste 2
New Bern, NC 28562-2610
Phone
(252) 336-3646
NPI assigned
Jul 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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 MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X P019450 NC Primary

Addresses

Primary practice location

1425 S Glenburnie Rd Ste 2
New Bern, NC 28562-2610

Mailing address

1425 S Glenburnie Rd Ste 2
New Bern, NC 28562-2610
Phone (252) 336-3646

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
P019450NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Great Place to Start Behavioral Health Services Clinical CurrentSince Jul 23, 2023 Accepting new patients

Locations

1425 S Glenburnie Rd
Ste 2
New Bern, NC 28562
Phone (252) 336-3646

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": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1558041756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S GLENBURNIE RD STE 2",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622610",
            "telephone_number": "252-336-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S GLENBURNIE RD STE 2",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622610",
            "telephone_number": "252-336-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWARD-LEARY",
        "first_name": "STEPHONIE",
        "middle_name": "DEONNE",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.