Marisha Larae Mathis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009792 Issued in NC

Practice address

4000 Wake Forest Rd Ste 200
Raleigh, NC 27609-6859

Phone

(919) 865-8710

NPI assigned

Apr 29, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Carolina Outreach, LLC

  • Clinical Social Worker
  • Durham, NC
  • NPI 1083723266
  Medicare reassignment NPD
• Thriveworks Clinical - North Carolina PC

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1003303082
  Medicare reassignment NPD
• Carolina Outreach, LLC

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1508171216

  Clinical

  NPD

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1609253681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 GARRETT RD",
            "address_2": "APT 534",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075950",
            "telephone_number": "919-824-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WAKE FOREST RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096859",
            "telephone_number": "919-865-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "MARISHA",
        "middle_name": "LARAE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie Philip Mathew, D.M.D.
• Vinod Verghese Mathew, D.D.S.
• Carolyn E Mathiot, PTA
• Jason Mathis, COTA/L
• Kristen Malibu Mathis, R.N.
• Patricia Ann Mathis
• Teimeka Mathis
• James Michael Mathues, MOT, OTR/L
• Tushar Mathur, MD
• Matrone Primary Care

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, 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 Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.