Active NPI
Kristen Danielle Gudipalli, MSW, LCSWA
- Clinical Social Worker
- Winston Salem, NC
National Provider Identifier
1821702184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P018267
- Practice address
- 810 Akron Dr
Winston Salem, NC 27105-3853 - Phone
- (336) 631-1948
- NPI assigned
- Jan 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P018267 | NC | Primary |
Addresses
Primary practice location
810 Akron Dr
Winston Salem, NC 27105-3853
Mailing address
551 Buchanan CT
Winston Salem, NC 27127-3894
Phone (757) 392-5491
Other practice location 1
153 Jefferson Church Rd Ste F
King, NC 27021-8605
Phone (336) 631-1948
Other practice location 2
113 N Crutchfield St
Dobson, NC 27017-8804
Phone (336) 356-2121
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
| License | State | Type | Specialty |
|---|---|---|---|
| P018267 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Counseling & Consulting Services, Inc. | Clinical | Current | Accepting new patients |
Locations
810 Akron Dr
Winston Salem, NC 27105
Phone (336) 631-1948
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Winston Salem, NC
- NPI 1164089207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1821702184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "551 BUCHANAN CT",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271273894",
"telephone_number": "757-392-5491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 AKRON DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271053853",
"telephone_number": "336-631-1948"
}
],
"practiceLocations": [
{
"address_1": "153 Jefferson Church Rd Ste F",
"address_purpose": "LOCATION",
"city": "King",
"state": "NC",
"postal_code": "270218605",
"country_code": "US",
"telephone_number": "336-631-1948",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "113 N Crutchfield St",
"address_purpose": "LOCATION",
"city": "Dobson",
"state": "NC",
"postal_code": "270178804",
"country_code": "US",
"telephone_number": "336-356-2121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUDIPALLI",
"first_name": "KRISTEN",
"middle_name": "DANIELLE",
"name_prefix": "Mrs.",
"credential": "MSW, LCSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-11",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P018267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.