Individual provider Active NPI

Sheresa Cherrel Elliot, BSW, MSW

  • Clinical Social Worker
  • Morehead City, NC
National Provider Identifier
1972098135
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P012703 Issued in NC
Practice address
3332 Bridges St Ste 3a
Morehead City, NC 28557-3296
Phone
(888) 557-1675
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 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 P012703 NC Primary

Addresses

Primary practice location

3332 Bridges St Ste 3a
Morehead City, NC 28557-3296

Mailing address

803 Pine St
Beaufort, NC 28516-1925
Phone (336) 602-7121

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
P012703NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1972098135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 PINE ST",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161925",
            "telephone_number": "336-602-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 BRIDGES ST STE 3A",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573296",
            "telephone_number": "888-557-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOT",
        "first_name": "SHERESA",
        "middle_name": "CHERREL",
        "credential": "BSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P012703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.