Cordelia Johnson Chavis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C016203 Issued in NC

Practice address

220 Wintergreen Dr Ste F
Lumberton, NC 28358-2188

Phone

(910) 536-0581

NPI assigned

Nov 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All-American Counseling WellnessGroup PAC ID 1850651076, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• All-American Counseling Wellness

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1104337625

  Clinical, NC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1982249298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 SANDCASTLE LN",
            "city": "LINDEN",
            "state": "NC",
            "postal_code": "283569437",
            "telephone_number": "833-846-3463",
            "fax_number": "855-510-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 WINTERGREEN DR STE F",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582188",
            "telephone_number": "910-536-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVIS",
        "first_name": "CORDELIA",
        "middle_name": "JOHNSON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Graham
• Nadia Farooq Chaudhry, MD
• Rehman Chaudhry, DO
• Brittany Renea Chavis, LCSWA
• Christan Chavis
• Danielle Nicole Chavis, PA-C
• Debra Chavis, MSW, LCSW-P
• Rhonda Chavis, SPEECH THERAPIST
• Stephanie Chavis, FNP-C
• Stephanie Brooks Chavis, M.S., LMFT

• Clinical Social Worker in Lumberton, NC
• Providers in Lumberton, 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 Nov 1, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.