Terri I Willard, CSAC, CCJP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSAC23880 Issued in NC

Practice address

5209 W Wendover Ave
High Point, NC 27265-9177

Phone

(336) 899-1550

NPI assigned

Jun 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1821657818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 W WENDOVER AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659177",
            "telephone_number": "336-899-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "TERRI",
        "middle_name": "I",
        "credential": "CSAC, CCJP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "CSAC23880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lee Wiles, RN, MHNP
• Eric Corbett Wilford
• Foster Wilkins
• Laura Elizabeth Wilkinson, PTA
• Garrett George Willard
• Virgil Victor Willard II, MD
• Shela Ann Williams-Stacey, LCSW, LCAS, CSI
• Alysha G. Williams
• Benjamin Allen Williams, DDS, PA
• Breejante Jerneisha Williams, PA-C

• Clinical Social Worker in High Point, NC
• Providers in High Point, 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 Jun 12, 2019; 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.