Individual provider Active NPI

Abena Bediako, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1598940769
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005909 Issued in NC
Practice address
113 Murray Hill Dr
Durham, NC 27712-3063
Phone
(919) 672-0712
Fax
(888) 806-1537
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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 C005909 NC Primary

Addresses

Primary practice location

113 Murray Hill Dr
Durham, NC 27712-3063

Mailing address

PO Box 11354
Durham, NC 27703-0354
Phone (919) 672-0712

Other identifiers 1

IdentifierTypeStateIssuer
6106834MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C005909NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1598940769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11354",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277030354",
            "telephone_number": "919-672-0712",
            "fax_number": "888-806-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MURRAY HILL DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277123063",
            "telephone_number": "919-672-0712",
            "fax_number": "888-806-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDIAKO",
        "first_name": "ABENA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106834",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.