John Bartholomew Doherty, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002579 Issued in NC

Practice address

120 Penmarc Dr
# 118
Raleigh, NC 27603-2400

Phone

(800) 632-6074

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Paradigm Health Psychiatric SRV, LLC

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1770533945
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1669401097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13575 58TH ST N",
            "address_2": "STE 187",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603740",
            "telephone_number": "800-632-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PENMARC DR",
            "address_2": "# 118",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032400",
            "telephone_number": "800-632-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "JOHN",
        "middle_name": "BARTHOLOMEW",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Doe
• Larissa Doede, FNP-BC
• Darcy Doggett, LMT,
• Dogwood Pediatric Therapy, PLLC
• Dogwood Springs Counseling PLLC
• Margaret M Doherty, PA
• Audrey Allison Doidge, LCMHCA
• Alexandra Doiron
• Jordan Rose Doiron
• Ashley Marie Dolan, PA-C

• 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 Jul 25, 2012; 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.