Individual provider Active NPI

Andrea Muro, LCSW

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1740509124
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006765 Issued in NC
Practice address
4421 Junction Park Dr
Suite 200
Wilmington, NC 28412-2263
Phone
(910) 515-6090
NPI assigned
May 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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 C006765 NC Primary

Addresses

Primary practice location

4421 Junction Park Dr
Suite 200
Wilmington, NC 28412-2263

Mailing address

2013 Metts Ave
Wilmington, NC 28403-2131
Phone (201) 803-1898

Other identifiers 1

IdentifierTypeStateIssuer
6007728MedicaidNC

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
C006765NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1740509124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 METTS AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032131",
            "telephone_number": "201-803-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 JUNCTION PARK DR",
            "address_2": "SUITE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122263",
            "telephone_number": "910-515-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURO",
        "first_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6007728",
            "state": "NC"
        }
    ],
    "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 Jul 23, 2013; 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.