Individual provider Active NPI

Vanessa Del Carmen, LCSW, LCAS

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1700494572
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015199 Issued in NC
Practice address
3125 Poplarwood CT
Raleigh, NC 27604-1084
Phone
(919) 744-6674
NPI assigned
Jul 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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 LCAS-26465 NC
Clinical Social Worker 1041C0700X C015199 NC Primary

Addresses

Primary practice location

3125 Poplarwood CT
Raleigh, NC 27604-1084

Mailing address

973 Garrison Ave
Clayton, NC 27520-8662
Phone (704) 408-0328

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
I20230405001534 NC Practitioner - Clinical Social Worker 8123493160 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-26465NCMDAddiction (Substance Use Disorder) Counselor
C015199NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southlight Healthcare CurrentSince Jan 1, 2023 Accepting new patients
Southlight Healthcare Addiction (Substance Use Disorder) CurrentSince Jan 1, 2023 Accepting new patients

Locations

2101 Old Garner Rd
Raleigh, NC 27610
Phone (919) 832-4453

3125 Poplarwood Ct
Ste 203
Raleigh, NC 27604
Phone (919) 457-8775

3117 Poplarwood Ct
Ste 115
Raleigh, NC 27604

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": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1700494572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 GARRISON AVE",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208662",
            "telephone_number": "704-408-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041084",
            "telephone_number": "919-744-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL CARMEN",
        "first_name": "VANESSA",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-26465",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.