Individual provider Active NPI

John N Von Der Lehr, LCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1962770487
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007553 Issued in NC
Practice address
1003 Saint Marys St
Raleigh, NC 27605-1232
Phone
(919) 802-5225
NPI assigned
Dec 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C007553 NC Primary
Clinical Social Worker 1041C0700X 58204 TX

Addresses

Primary practice location

1003 Saint Marys St
Raleigh, NC 27605-1232

Mailing address

1003 Saint Marys St
Raleigh, NC 27605-1232
Phone (919) 802-5225

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151118002978 NC Practitioner - Clinical Social Worker 2466678404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindly Group, PLLCGroup PAC ID 3072744028, 7 clinicians

Practice addresses (Care Compare)

501 Keisler Dr
Suite 104
Cary, NC 27518-9322
Phone (919) 617-9656

8406 Six Forks Rd
Suite 204
Raleigh, NC 27615-3074
Phone (919) 617-9656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C007553NCMDClinical Social Worker
58204TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindly Group, PLLC Clinical CurrentSince Oct 16, 2015 Accepting new patients

Locations

501 Keisler Dr
Ste 104
Cary, NC 27518
Phone (919) 617-9656

8406 Six Forks Rd
Ste 201
Raleigh, NC 27615
Phone (919) 617-9656

8406 Six Forks Rd
Ste 204
Raleigh, NC 27615
Phone (919) 617-9656

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1962770487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 SAINT MARYS ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051232",
            "telephone_number": "919-802-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 SAINT MARYS ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051232",
            "telephone_number": "919-802-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON DER LEHR",
        "first_name": "JOHN",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007553",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.