Active NPI
Alyssa Hermanson, LCSW-A
- Clinical Social Worker
- Jacksonville, NC
National Provider Identifier
1851932909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P013485
- Practice address
- 3886 Henderson Dr
Jacksonville, NC 28546-5219 - Phone
- (910) 938-9833
- Fax
- (910) 938-9835
- NPI assigned
- Sep 30, 2019
- 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 | P013485 | NC | Primary |
Addresses
Primary practice location
3886 Henderson Dr
Jacksonville, NC 28546-5219
Mailing address
3886 Henderson Dr
Jacksonville, NC 28546-5219
Phone (910) 938-9833
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P013485 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renewed Wellness Counseling, PLLC | Clinical | Current | Accepting new patients |
| Pride in North Carolina, LLC | Past | Accepting new patients | |
| Easter Seals Ucp North Carolina & Virginia, Inc. | Past | Accepting new patients |
Locations
312 S Front St
Ste 7
New Bern, NC 28560
Phone (252) 505-8150
509 Broad St
Unit 1
New Bern, NC 28560
3537 Martin Luther King Jr Blvd
New Bern, NC 28562
Phone (252) 505-8150
Organizations & group practices 3
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
- New Bern, NC
- NPI 1942829023
-
- Pharmacy
- New Bern, NC
- NPI 1013769629
-
- Community/Behavioral Health Agency
- Jacksonville, NC
- NPI 1821136581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608163200000",
"number": "1851932909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3886 HENDERSON DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465219",
"telephone_number": "910-938-9833",
"fax_number": "910-938-9835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3886 HENDERSON DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465219",
"telephone_number": "910-938-9833",
"fax_number": "910-938-9835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMANSON",
"first_name": "ALYSSA",
"credential": "LCSW-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-30",
"last_updated": "2020-12-17",
"certification_date": "2020-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P013485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.