Active NPI
Wendy D Maddox, LCSW
- Clinical Social Worker
- Havelock, NC
National Provider Identifier
1689934341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C007740
- Practice address
- Building 87 Roosevelt Blvd
PSC Box 8009
Havelock, NC 28533 - Phone
- (252) 466-3651
- NPI assigned
- May 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | C007740 | NC | Primary |
Addresses
Primary practice location
Building 87 Roosevelt Blvd
PSC Box 8009
Havelock, NC 28533
Mailing address
PSC Box 8009
Building 87
Havelock, NC 28533
Phone (252) 466-3651
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C007740 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338249600000",
"number": "1689934341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PSC BOX 8009",
"address_2": "BUILDING 87",
"city": "HAVELOCK",
"state": "NC",
"postal_code": "28533",
"telephone_number": "252-466-3651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BUILDING 87 ROOSEVELT BLVD",
"address_2": "PSC BOX 8009",
"city": "HAVELOCK",
"state": "NC",
"postal_code": "28533",
"telephone_number": "252-466-3651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "WENDY",
"middle_name": "D",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-29",
"last_updated": "2012-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C007740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havelock, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.