Individual provider Active NPI

Rebecca L Lyman

  • Clinical Social Worker
  • Raeford, NC
National Provider Identifier
1649876673
Registry record updated Dec 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PO14647 Issued in NC
Practice address
402 Harris Ave
Raeford, NC 28376-3112
Phone
(910) 875-5590
NPI assigned
Dec 6, 2020
Last updated
Dec 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2020

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 PO14647 NC Primary

Addresses

Primary practice location

402 Harris Ave
Raeford, NC 28376-3112

Mailing address

135 Covenant Rd
Whispering Pines, NC 28327-9495
Phone (256) 453-4113

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231121001195 NC Practitioner - Clinical Social Worker 3173971710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Vision Counseling and Consulting Agency PLLCGroup PAC ID 5698049476, 6 clinicians

Practice addresses (Care Compare)

402 Harris Ave
Raeford, NC 28376-3112
Phone (910) 875-5590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO14647NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Vision Counseling & Consulting Agency PLLC Clinical CurrentSince Aug 23, 2023 Accepting new patients

Locations

402 Harris Ave
Raeford, NC 28376
Phone (910) 848-1638

101 Bradford Village Ct
Southern Pines, NC 28387
Phone (910) 684-8750

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

NPI Registry JSON

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

{
    "created_epoch": "1607212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607212800000",
    "number": "1649876673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 COVENANT RD",
            "city": "WHISPERING PINES",
            "state": "NC",
            "postal_code": "283279495",
            "telephone_number": "256-453-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 HARRIS AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763112",
            "telephone_number": "910-875-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "REBECCA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-06",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "PO14647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.