Individual provider Active NPI

Elizabeth Schuyler Vaughan Coonse, LCSW-A

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1932606837
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P011551 Issued in NC
Practice address
508 Maylands Ave
Raleigh, NC 27615-7334
Phone
(919) 633-9002
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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 P011551 NC Primary

Addresses

Primary practice location

508 Maylands Ave
Raleigh, NC 27615-7334

Mailing address

408 Maylands Ave
Raleigh, NC 27615-7331
Phone (919) 633-9002

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
P011551NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1932606837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 MAYLANDS AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157331",
            "telephone_number": "919-633-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 MAYLANDS AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276157334",
            "telephone_number": "919-633-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN COONSE",
        "first_name": "ELIZABETH",
        "middle_name": "SCHUYLER",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.