NPIMap

Organization Active NPI

Carolina Wellness Services PLLC

  • Clinical Social Worker
  • Ellerbe, NC
National Provider Identifier
1740820216
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CAROLINA WELLNESS SERVICES PLLC
Practice address
223 Wallace Rd
Ellerbe, NC 28338-9304
Phone
(910) 995-1541
NPI assigned
Jan 13, 2020
Last updated
Jan 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Jessica Sybil Sawyer Horne, MSW, LCSW, LCAS, CCSNPI 1962520536
Title
Member-Manager
Phone
(910) 995-1541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

223 Wallace Rd
Ellerbe, NC 28338-9304

Mailing address

PO Box 597
Ellerbe, NC 28338-0597

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1740820216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "ELLERBE",
            "state": "NC",
            "postal_code": "283380597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 WALLACE RD",
            "city": "ELLERBE",
            "state": "NC",
            "postal_code": "283389304",
            "telephone_number": "910-995-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA WELLNESS SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "SAWYER HORNE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "SYBIL",
        "authorized_official_title_or_position": "MEMBER-MANAGER",
        "authorized_official_telephone_number": "910-995-1541",
        "authorized_official_credential": "MSW, LCSW, LCAS, CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellerbe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.