Active NPI
Elisa Ford, LCSW
- Clinical Social Worker
- Durham, NC
National Provider Identifier
1770158487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C010305
- Practice address
- 4430 Ryan St
Durham, NC 27704-1808 - Phone
- (919) 608-7577
- NPI assigned
- May 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | C010305 | NC | Primary |
Addresses
Primary practice location
4430 Ryan St
Durham, NC 27704-1808
Mailing address
4430 Ryan St
Durham, NC 27704-1808
Phone (919) 608-7577
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
| License | State | Type | Specialty |
|---|---|---|---|
| C010305 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1770158487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4430 RYAN ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041808",
"telephone_number": "919-608-7577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4430 RYAN ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041808",
"telephone_number": "919-608-7577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "ELISA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-25",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C010305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.