Rebecca Jyll Siwanowicz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C016256 Issued in NC

Practice address

284 Executive Park Dr
Concord, NC 28025-1831

Phone

(704) 939-1100

Fax

(704) 939-1173

NPI assigned

May 7, 2021

Sex

Female

Sole proprietor

No

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, FL, IL, CT4 enrollments

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 4

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as group

Quality

89.03

Promoting interoperability

82

Improvement activities

40

Cost

90.28

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MCCD FL Psychiatry Services PA

  dba Talkiatry

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  NC

  Medicare reassignment Care Compare group NPD
• Daymark Recovery Services, Inc.

  • Multi-Specialty Clinic/Center
  • Concord, NC
  • NPI 1558329243

  Clinical

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, CT, IL, NC

  Medicare reassignment NPD
• Solas Health PLLC

  • Anesthesiology Physician
  • Pinehurst, NC
  • NPI 1710046925
  NPD
• Pinehurst OBGYN Associates PA

  • Obstetrics & Gynecology Physician
  • Pinehurst, NC
  • NPI 1710057443
  NPD (past)
• Elevate Youth Recovery, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Davie, FL
  • NPI 1861380974
  NPD (past)
• Recovery in Tune, LLC

  • Substance Abuse Rehabilitation Facility
  • Stuart, FL
  • NPI 1679952345
  NPD (past)

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1780268672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 NC 87 S",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273320212",
            "telephone_number": "954-235-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251831",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 Nc 87 S",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "NC",
            "postal_code": "273320212",
            "country_code": "US",
            "telephone_number": "910-477-8244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIWANOWICZ",
        "first_name": "REBECCA",
        "middle_name": "JYLL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16961",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travasia Eterniti Dubose Singletary-Scott
• Samuel Sirakanyan, PSY.D.
• Krista Sirois, MD
• Providence Sisomphou
• Zellua Sistrunk Moore, MSW, LCSWA
• Gracie Ann Sizemore
• Laura Skaff, PHARMD
• James Raymond Skahen III, MD
• Cora Skillman-Woods
• Latisha Faye Skinkle, APRN

• Clinical Social Worker in Concord, NC
• Providers in Concord, 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 Feb 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.