Individual provider Active NPI

Elizabeth T Maino, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1821294380
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C012186
Practice address
2102 Cambridge Beltway Dr Ste E
Charlotte, NC 28273-4354
Phone
(704) 799-6824
Fax
(704) 799-6825
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 30403 TX
Clinical Social Worker 1041C0700X C012186 Primary

Addresses

Primary practice location

2102 Cambridge Beltway Dr Ste E
Charlotte, NC 28273-4354

Mailing address

134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824

Other practice location 1

129 Woodson St
Salisbury, NC 28144-3255
Phone (704) 799-6824

Other practice location 2

134 Infield Ct
Mooresville, NC 28117-8026
Phone (704) 799-6824

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230501000133 NC Practitioner - Clinical Social Worker 0840655601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30403TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Mar 21, 2023 Accepting new patients
Lolly Therapeutics, LLC Clinical Past Accepting new patients
Integrative Therapy Concepts Past Accepting new patients
Family First Community Services, LLC Clinical Past Accepting new patients
Family First Community Services LLC Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1821294380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 CAMBRIDGE BELTWAY DR STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734354",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Woodson St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281443255",
            "country_code": "US",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "134 Infield Ct",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281178026",
            "country_code": "US",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAINO",
        "first_name": "ELIZABETH",
        "middle_name": "T",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "30403",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "C012186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.