Individual provider Active NPI

Charles Curtis Yarborough

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1740320654
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3632 Issued in HI
Practice address
736 Medical Center Dr
Suite 102
Wilmington, NC 28401-4170
Phone
(910) 763-5979
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3632 HI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1465-09 HI

Addresses

Primary practice location

736 Medical Center Dr
Suite 102
Wilmington, NC 28401-4170

Mailing address

134 Grand Champion Rd
Wilmington, NC 28412-2614
Phone (808) 780-6420

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

LicenseStateTypeSpecialty
1465-09HIMDAddiction (Substance Use Disorder) Counselor
3632HIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1740320654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 GRAND CHAMPION RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122614",
            "telephone_number": "808-780-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 MEDICAL CENTER DR",
            "address_2": "SUITE 102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284014170",
            "telephone_number": "910-763-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARBOROUGH",
        "first_name": "CHARLES",
        "middle_name": "CURTIS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3632",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "HI",
            "license": "1465-09",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.