Individual provider Active NPI

Brenda Robinson Ward, LCSW, LCAS

  • Clinical Social Worker
  • Concord, NC
National Provider Identifier
1649312646
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C000781 Issued in NC
Practice address
212 Le Phillip CT
Suite 106
Concord, NC 28025-2984
Phone
(704) 782-3004
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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 1074 NC
Clinical Social Worker 1041C0700X C000781 NC Primary

Addresses

Primary practice location

212 Le Phillip CT
Suite 106
Concord, NC 28025-2984

Mailing address

2677 Saddlewood Cir SW
Concord, NC 28027-1018
Phone (704) 786-6817

Other identifiers 1

IdentifierTypeStateIssuer
6106476MedicaidNC

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
1074NCMDAddiction (Substance Use Disorder) Counselor
C000781NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Past Accepting new patients
Act Medical Group PA Past Accepting new patients

Organizations & group practices 2

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1649312646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 SADDLEWOOD CIR SW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280271018",
            "telephone_number": "704-786-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 LE PHILLIP CT",
            "address_2": "SUITE 106",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252984",
            "telephone_number": "704-782-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "BRENDA",
        "middle_name": "ROBINSON",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1074",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106476",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.