Individual provider Active NPI

Madeline Brophy Wieman, LCSW

  • Clinical Social Worker
  • Hampstead, NC
National Provider Identifier
1992478192
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
201 Alston Blvd
Ste C PMB 1003
Hampstead, NC 28443-7011
Phone
(910) 212-6757
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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 Primary

Addresses

Primary practice location

201 Alston Blvd
Ste C PMB 1003
Hampstead, NC 28443-7011

Mailing address

201 Alston Blvd
Ste C PMB 1003
Hampstead, NC 28443-7011
Phone (910) 212-6757

Other names 1

  • Madeline Brophy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 26, 2024 through Aug 26, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Therapy, P.L.L.C. Clinical CurrentSince Apr 9, 2024 Accepting new patients

Locations

201 Alston Blvd
Ste C
Hampstead, NC 28443
Phone (910) 212-6757

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1992478192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ALSTON BLVD",
            "address_2": "STE C PMB 1003",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284437011",
            "telephone_number": "910-212-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ALSTON BLVD",
            "address_2": "STE C PMB 1003",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284437011",
            "telephone_number": "910-212-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEMAN",
        "first_name": "MADELINE",
        "middle_name": "BROPHY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "BROPHY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hampstead, NC

Sources for this page

Verify at the official NPI Registry.