Individual provider Active NPI

George Timothy Dennard, PLCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1972745453
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P003356 Issued in NC
Practice address
820 S Boylan Ave
Raleigh, NC 27603-2246
Phone
(919) 715-5733
Fax
(919) 733-0911
NPI assigned
Mar 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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 P003356 NC Primary

Addresses

Primary practice location

820 S Boylan Ave
Raleigh, NC 27603-2246

Mailing address

820 S Boylan Ave
Raleigh, NC 27603-2246
Phone (919) 715-5733

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
P003356NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1972745453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S BOYLAN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032246",
            "telephone_number": "919-715-5733",
            "fax_number": "919-733-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S BOYLAN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032246",
            "telephone_number": "919-715-5733",
            "fax_number": "919-733-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNARD",
        "first_name": "GEORGE",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "PLCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P003356",
            "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 Mar 31, 2009; 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.