Jason Lee Radosevich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C011345 Issued in NC

Practice address

100 Billingsley Rd
Charlotte, NC 28211-1002

Phone

(704) 376-7447

NPI assigned

May 12, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anuvia Prevention & Recovery, Center, Inc.

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1093756819
  Medicare reassignment NPD
• Anuvia Prevention and Recovery Center, Inc

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1154706307
  NPD (past)

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1750792800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 SULLIVAN RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773437",
            "telephone_number": "704-871-0934",
            "fax_number": "704-402-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BILLINGSLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111002",
            "telephone_number": "704-376-7447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 W Lebanon St",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "NC",
            "postal_code": "270302954",
            "country_code": "US",
            "telephone_number": "336-789-9492",
            "fax_number": "336-789-9587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 Sullivan Rd",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286773437",
            "country_code": "US",
            "telephone_number": "704-871-0934",
            "fax_number": "704-402-1065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADOSEVICH",
        "first_name": "JASON",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P008656",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Anne Rader
• Erica Rader, DMD
• Darryl E Radford Sr., REVEREND
• Bethany Leigh Radgowski, MSW, LCSW
• Radiance Healthcare Group, LLC
• Rae's Playze Adult Day Center
• Rafael Rivera, Jr, DDS, PLLC (SmileStarters)
• Rafael Rivera, Jr., DDS, PLLC (SmileStarters)
• Maureen Rafferty, MD
• Rebecca Lydia Raffler, DO

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.