Individual provider Active NPI

Carrie Beaver Ross, LCSW

  • Clinical Social Worker
  • Hickory, NC
National Provider Identifier
1730487406
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007174 Issued in NC
Practice address
3050 11TH Avenue Dr SE
Hickory, NC 28602-8336
Phone
(828) 695-6585
Fax
(828) 695-4729
NPI assigned
Mar 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C007174 NC Primary

Addresses

Primary practice location

3050 11TH Avenue Dr SE
Hickory, NC 28602-8336

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-9005

Other practice location 1

338 W 15th St
Newton, NC 28658-2906
Phone (828) 465-0920

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

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1730487406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-9005",
            "fax_number": "704-874-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 11TH AVENUE DR SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028336",
            "telephone_number": "828-695-6585",
            "fax_number": "828-695-4729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "338 W 15th St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "NC",
            "postal_code": "286582906",
            "country_code": "US",
            "telephone_number": "828-465-0920",
            "fax_number": "828-464-1412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CARRIE",
        "middle_name": "BEAVER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.