Individual provider Active NPI

Heidi Dale Woodgeard, LCAS, LCSWA

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1609254663
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P009492 Issued in NC
Practice address
3300 Battleground Ave Ste 202
Greensboro, NC 27410
Phone
(336) 285-7173
Fax
(336) 285-7174
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS21250 NC
Clinical Social Worker 1041C0700X P009492 NC Primary

Addresses

Primary practice location

3300 Battleground Ave Ste 202
Greensboro, NC 27410

Mailing address

PO Box 4256
Archdale, NC 27263-4256
Phone (336) 848-3087

Other practice location 1

2301 W Meadowview Rd
Suite 101
Greensboro, NC 27407-3723
Phone (336) 907-7819

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
LCAS21250NCMDAddiction (Substance Use Disorder) Counselor
P009492NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sel Group PastSince Nov 5, 2017 Accepting new patients

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": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1609254663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4256",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272634256",
            "telephone_number": "336-848-3087",
            "fax_number": "336-792-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 BATTLEGROUND AVE STE 202",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27410",
            "telephone_number": "336-285-7173",
            "fax_number": "336-285-7174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 W Meadowview Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274073723",
            "country_code": "US",
            "telephone_number": "336-907-7819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODGEARD",
        "first_name": "HEIDI",
        "middle_name": "DALE",
        "credential": "LCAS, LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS21250",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P009492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.