Active NPI
Maura Katherine Bourne, MSW, LCSWA
- Clinical Social Worker
- Cary, NC
National Provider Identifier
1962153791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P017171
- Practice address
- 539 Keisler Dr Ste 102
Cary, NC 27518-9320 - Phone
- (919) 551-7900
- NPI assigned
- Jan 13, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PO17171 | NC | |
| Clinical Social Worker | 1041C0700X | P017171 | NC | Primary |
Addresses
Primary practice location
539 Keisler Dr Ste 102
Cary, NC 27518-9320
Mailing address
539 Keisler Dr Ste 102
Cary, NC 27518-9320
Other practice location 1
3000 Highwoods Blvd
Raleigh, NC 27604-1027
Phone (919) 714-7500
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | maura@ncPsychologist.com | Direct |
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 |
|---|---|---|---|
| PO17171 | NC | MD | Mental Health Counselor |
| P017171 | NC | MD | Clinical Social Worker |
Interoperability endpoints
- maura@ncpsychologist.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671148800000",
"number": "1962153791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "539 KEISLER DR STE 102",
"city": "CARY",
"state": "NC",
"postal_code": "275189320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "539 KEISLER DR STE 102",
"city": "CARY",
"state": "NC",
"postal_code": "275189320",
"telephone_number": "919-551-7900"
}
],
"practiceLocations": [
{
"address_1": "3000 Highwoods Blvd",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276041027",
"country_code": "US",
"telephone_number": "919-714-7500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOURNE",
"first_name": "MAURA",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "MSW, LCSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-13",
"last_updated": "2022-12-16",
"certification_date": "2022-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "PO17171",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P017171",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "maura@ncPsychologist.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "539 Keisler Dr Ste 102",
"city": "Cary",
"state": "NC",
"country_code": "US",
"postal_code": "275189320",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.