NPIMap

Organization Active NPI

Deirdre W. Street, LLC

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1821346313
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007674 Issued in NC
Legal business name
DEIRDRE W. STREET, LLC
Practice address
6209 Oleander Dr
Suite 102-2
Wilmington, NC 28403-3581
Phone
(910) 233-0052
NPI assigned
Aug 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Authorized official

Name
Deirdre W Street, LCSWNPI 1346595758
Title
Licensed Clinical Social Worker
Phone
(910) 233-0052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C007674 NC Primary

Addresses

Primary practice location

6209 Oleander Dr
Suite 102-2
Wilmington, NC 28403-3581

Mailing address

6209 Oleander Dr
Suite 102-2
Wilmington, NC 28403-3581
Phone (910) 233-0052

National Provider Directory

National Provider Directory

Locations

6209 Oleander Dr
Ste 102-2
Wilmington, NC 28403
Phone (910) 233-0052

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1821346313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 OLEANDER DR",
            "address_2": "SUITE 102-2",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033581",
            "telephone_number": "910-233-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 OLEANDER DR",
            "address_2": "SUITE 102-2",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033581",
            "telephone_number": "910-233-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEIRDRE W. STREET, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "910-233-0052",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.