Individual provider Active NPI

Eileen Blum Nardin, LCSW, ACSW

  • Clinical Social Worker
  • Apex, NC
National Provider Identifier
1740310325
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C002841 Issued in NC
Practice address
1071 Pemberton Hill Rd
Suite 201
Apex, NC 27502-4268
Phone
(919) 367-0404
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 C002841 NC Primary

Addresses

Primary practice location

1071 Pemberton Hill Rd
Suite 201
Apex, NC 27502-4268

Mailing address

1071 Pemberton Hill Rd
Suite 201
Apex, NC 27502-4268
Phone (919) 367-0404

Other identifiers 1

IdentifierTypeStateIssuer
1258HOtherNCBCBS OF NC

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

LicenseStateTypeSpecialty
C002841NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740310325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 PEMBERTON HILL RD",
            "address_2": "SUITE 201",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024268",
            "telephone_number": "919-367-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 PEMBERTON HILL RD",
            "address_2": "SUITE 201",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024268",
            "telephone_number": "919-367-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARDIN",
        "first_name": "EILEEN",
        "middle_name": "BLUM",
        "name_prefix": "Ms.",
        "credential": "LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "1258H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.