Erin E Gaudreault, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C011501 Issued in NC

Practice address

150 W. Vermont Avenue
Southern Pines, NC 28387-4823

Phone

(540) 729-7097

NPI assigned

Nov 4, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 3, 2018 through Jan 3, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1972830453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 PINEWILD DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749735",
            "telephone_number": "540-729-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W. VERMONT AVENUE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283874823",
            "telephone_number": "540-729-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUDREAULT",
        "first_name": "ERIN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011501",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Garner, WHNP-BC
• Winston Joseph Garris, MD
• Rachel Leigh Gary, RDN, LDN
• Timothy Michael Gast, PA-C
• Ellen Mae Gaudlip, MD
• Hugh Perry Gayman Jr., PT
• Laurel Dell Gentry, PHARMD
• Brady B George, DMD
• Michelle Marie Gerardot, LCSW
• Kimberly Giliberti

• Clinical Social Worker in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.