Individual provider Active NPI

Casey Richardson, C014375

  • Clinical Social Worker
  • New Bern, NC
National Provider Identifier
1972928174
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C014375 Issued in NC
Practice address
509 Broad St Ste C
New Bern, NC 28560-4803
Phone
(805) 418-0456
NPI assigned
Feb 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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 C014375 NC Primary
Clinical Social Worker 1041C0700X P013296 NC

Addresses

Primary practice location

509 Broad St Ste C
New Bern, NC 28560-4803

Mailing address

1140 Amberjack CT
New Bern, NC 28562-1019
Phone (805) 418-0456

Other practice location 1

2407 Grace Ave
New Bern, NC 28562-4416
Phone (805) 418-0456

Other practice location 2

1140 Amberjack Ct
New Bern, NC 28562
Phone (805) 418-0456

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
I20221207001979 NC Practitioner - Clinical Social Worker 6608245048 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P013296NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Excellence Behavioral Health Services, PLLC Clinical CurrentSince Jul 12, 2023 Accepting new patients
A Fresh Start Behavioral Health Services, PLLC Clinical CurrentSince Aug 25, 2022 Accepting new patients
Imperial Counseling & Coaching Services, LLC Clinical Past Accepting new patients

Locations

509 Broad St
Ste C
New Bern, NC 28560
Phone (252) 631-6260

2407 Grace Ave
Trent Woods, NC 28562
Phone (252) 514-7766

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1972928174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 AMBERJACK CT",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285621019",
            "telephone_number": "805-418-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 BROAD ST STE C",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285604803",
            "telephone_number": "805-418-0456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2407 Grace Ave",
            "address_purpose": "LOCATION",
            "city": "New Bern",
            "state": "NC",
            "postal_code": "285624416",
            "country_code": "US",
            "telephone_number": "805-418-0456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1140 Amberjack Ct",
            "address_purpose": "LOCATION",
            "city": "New Bern",
            "state": "NC",
            "postal_code": "28562",
            "country_code": "US",
            "telephone_number": "805-418-0456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CASEY",
        "credential": "C014375",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014375",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.