Andrea Eaves, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004198 Issued in NC

Practice address

353 W 2ND St
Clayton, NC 27520-2336

Phone

(919) 271-0135

Fax

(888) 503-6822

NPI assigned

May 15, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Group practices

Into the Light Counseling IncGroup PAC ID 3870739709, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Into the Light Counseling, Inc.

  • Clinical Social Worker
  • Clayton, NC
  • NPI 1689925562
  Medicare reassignment Care Compare group NPD Authorized official
• Carolina Counseling & Consultation Services

  • Mental Health Counselor
  • Smithfield, NC
  • NPI 1902859333
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1700837630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 TWO DOES DR.",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "27520",
            "telephone_number": "919-271-0135",
            "fax_number": "888-503-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 W 2ND ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202336",
            "telephone_number": "919-271-0135",
            "fax_number": "888-503-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAVES",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "141C3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003393",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William C Durant, MD
• Durham Vamc
• Elfreda Ami Dzukey
• Early Speech Services.
• Marcy Davenport Eaton, PA-C
• Edc Drug Stores Inc (Rite Aid Pharmacy 11369)
• Edward T. Kryn, MD, PA
• Bryan Terence Edwards, PA-C
• William Samuel Eggleston, OD
• Elements of Speech, Speech-Language Therapy, PLLC

• Clinical Social Worker in Clayton, NC
• Providers in Clayton, 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 Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.