Active NPI
Carol Ann Queen
- Clinical Social Worker
- Mebane, NC
National Provider Identifier
1760159438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C016290
- Practice address
- 632 Gibson Rd
Mebane, NC 27302-9130 - Phone
- (760) 267-7495
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C016290 | NC | Primary |
Addresses
Primary practice location
632 Gibson Rd
Mebane, NC 27302-9130
Mailing address
632 Gibson Rd
Mebane, NC 27302-9130
Phone (760) 267-7495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C016290 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1760159438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 GIBSON RD",
"city": "MEBANE",
"state": "NC",
"postal_code": "273029130",
"telephone_number": "760-267-7495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "632 GIBSON RD",
"city": "MEBANE",
"state": "NC",
"postal_code": "273029130",
"telephone_number": "760-267-7495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEEN",
"first_name": "CAROL",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C016290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mebane, NC
- Erich Freywald Priest, MSW, LCSW
- Private Diagnostic Clinic, PLLC
- Private Diagnostic Clinic, PLLC.
- Purity of Minds
- Purity of Minds Therapeutic Services & Mental Health Apparel, PLLC
- Janette Ramirez, M.S. CCC-SLP
- Natashia Rea, REGISTERED NURSE
- Zoe B Read
- Reebye Park & Richman DDS PLC
- Marilyn J Reed, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.