Individual provider Active NPI

Sandra Sofia Barrera, LCSWA

  • Clinical Social Worker
  • Winston Salem, NC
National Provider Identifier
1871041483
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P010788 Issued in NC
Practice address
4401 Providence LN
Suite 121
Winston Salem, NC 27106-3226
Phone
(336) 896-1323
Fax
(336) 896-1327
NPI assigned
Sep 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P010788 NC Primary

Addresses

Primary practice location

4401 Providence LN
Suite 121
Winston Salem, NC 27106-3226

Mailing address

4401 Providence LN
Suite 121
Winston Salem, NC 27106-3226
Phone (336) 896-1323

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

LicenseStateTypeSpecialty
P010788NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1871041483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 PROVIDENCE LN",
            "address_2": "SUITE 121",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063226",
            "telephone_number": "336-896-1323",
            "fax_number": "336-896-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PROVIDENCE LN",
            "address_2": "SUITE 121",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063226",
            "telephone_number": "336-896-1323",
            "fax_number": "336-896-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRERA",
        "first_name": "SANDRA",
        "middle_name": "SOFIA",
        "name_prefix": "Ms.",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010788",
            "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 Sep 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.