Active NPI
Charlene D Irvin
- Clinical Social Worker
- Southport, NC
National Provider Identifier
1992070122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C007450
- Practice address
- 4006 Norseman Loop
Unit 2
Southport, NC 28461-8234 - Phone
- (910) 620-6451
- NPI assigned
- Mar 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C007450 | NC | Primary |
| Clinical Social Worker | 1041C0700X | CW014331 | PA |
Addresses
Primary practice location
4006 Norseman Loop
Unit 2
Southport, NC 28461-8234
Mailing address
4006 Norseman Loop
Unit 2
Southport, NC 28461-8234
Phone (910) 620-6451
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
| License | State | Type | Specialty |
|---|---|---|---|
| C007450 | NC | MD | Clinical Social Worker |
| CW014331 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1992070122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4006 NORSEMAN LOOP",
"address_2": "UNIT 2",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284618234",
"telephone_number": "910-620-6451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4006 NORSEMAN LOOP",
"address_2": "UNIT 2",
"city": "SOUTHPORT",
"state": "NC",
"postal_code": "284618234",
"telephone_number": "910-620-6451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRVIN",
"first_name": "CHARLENE",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-21",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C007450",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW014331",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southport, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.