Mary Gerideau, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P010229 Issued in NC

Practice address

2003 Godwin Ave
Suite C
Lumberton, NC 28358-3149

Phone

(910) 674-4814

NPI assigned

Mar 30, 2016

Last updated

Mar 30, 2016By the provider in NPPES

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of North Carolina PCGroup PAC ID 5092120030, 175 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Behavioral Care of North Carolina, PC

  dba Carolina Behavioral Care Centers

  • Counseling Psychologist
  • Hillsborough, NC
  • NPI 1629843933
  Medicare reassignment Care Compare group NPD
• Carelon Behavioral Care, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boston, MA
  • NPI 1053894790

  NC

  Medicare reassignment NPD
• Carelon Medical Partners of North Carolina PC

  • Family Medicine Physician
  • Raleigh, NC
  • NPI 1659775831
  NPD
• Optum Behavioral Care of North Carolina, PC

  • Counseling Psychologist
  • Charlotte, NC
  • NPI 1427823749
  NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1861371718
  NPD

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1619330453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 GODWIN AVE",
            "address_2": "SUITE C",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583149",
            "telephone_number": "910-674-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 GODWIN AVE",
            "address_2": "SUITE C",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583149",
            "telephone_number": "910-674-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERIDEAU",
        "first_name": "MARY",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsten Gateless, DO
• Indravadan Sakarlal Gatiwala, M.D.
• Allan Gentry
• Laura Iris Gerald, M.D.
• Dixon William Gerber, M.D.
• Pradeep Ghimire, MD
• William Timothy Giddens, PHARMACIST
• Jessica Marie Gilbreath, MS, LCAS, CSI
• Jordan Michael Glaser, M.D.
• Sharleen Glass, NP

• Clinical Social Worker in Lumberton, NC
• Providers in Lumberton, 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 Mar 30, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.