Active NPI
Polly H King, LCSW
- Clinical Social Worker
- Pinehurst, NC
National Provider Identifier
1679735401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C005303
- Practice address
- 35 Memorial Dr
Pinehurst, NC 28374-8708 - Phone
- (910) 715-3370
- Fax
- (910) 715-3284
- NPI assigned
- Jul 2, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C005303 | NC | Primary |
Addresses
Primary practice location
35 Memorial Dr
Pinehurst, NC 28374-8708
Mailing address
35 Memorial Dr
Pinehurst, NC 28374-8708
Phone (910) 715-3370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C005303 | Other | NC | LCSW - C005303 |
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
| License | State | Type | Specialty |
|---|---|---|---|
| C005303 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1679735401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 MEMORIAL DR",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283748708",
"telephone_number": "910-715-3370",
"fax_number": "910-715-3284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 MEMORIAL DR",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283748708",
"telephone_number": "910-715-3370",
"fax_number": "910-715-3284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "POLLY",
"middle_name": "H",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-02",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C005303",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW - C005303",
"identifier": "C005303",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pinehurst, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.