Individual provider Active NPI

Elisa Mayes-Maher

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1801339304
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P010871 Issued in NC
Practice address
690 N Reilly Rd Ste 104
Fayetteville, NC 28303-5724
Phone
(910) 879-6102
Fax
(910) 882-8348
NPI assigned
Dec 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P010871 NC Primary

Addresses

Primary practice location

690 N Reilly Rd Ste 104
Fayetteville, NC 28303-5724

Mailing address

5900 Chason Ridge Dr Apt C
Fayetteville, NC 28314-4400
Phone (215) 768-4824

Other names 1

  • Mrs. Elisa Mayes Professional name

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

LicenseStateTypeSpecialty
P010871NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1801339304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 CHASON RIDGE DR APT C",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283144400",
            "telephone_number": "215-768-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 N REILLY RD STE 104",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035724",
            "telephone_number": "910-879-6102",
            "fax_number": "910-882-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYES-MAHER",
        "first_name": "ELISA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "MAYES",
            "prefix": "MRS.",
            "credential": "MSW, LCSW-A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.