Active NPI
Mary Roman, LCSWA
- Social Worker
- Fayetteville, NC
National Provider Identifier
1861957920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- P013056
- Practice address
- 6245 Cliffdale Rd
Fayetteville, NC 28314-2126 - Phone
- (808) 222-5174
- NPI assigned
- Feb 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | P013056 | NC | Primary |
Addresses
Primary practice location
6245 Cliffdale Rd
Fayetteville, NC 28314-2126
Mailing address
179 Ironwood Way
Raeford, NC 28376-6292
Phone (808) 222-5174
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 |
|---|---|---|---|
| P013056 | NC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549238400000",
"number": "1861957920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 IRONWOOD WAY",
"city": "RAEFORD",
"state": "NC",
"postal_code": "283766292",
"telephone_number": "808-222-5174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6245 CLIFFDALE RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283142126",
"telephone_number": "808-222-5174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "MARY",
"name_prefix": "Mrs.",
"credential": "LCSWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-04",
"last_updated": "2019-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NC",
"license": "P013056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.