Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jerome Fitzgerald Cornwall, LCSW

Individual provider Clinical Social Worker · NPI 1952775629

Mr. Jerome Fitzgerald Cornwall, LCSW is a Clinical Social Worker in Raleigh, North Carolina. Qualified in 2014, 12 years ago. Practices with Avance Care PA, a 244-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
12
Licensed in
NC
In the registry since
2015
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

7850 Brier Creek Pkwy Ste 100
Raleigh, NC 27617-8900
Phone: (919) 237-1337
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 110 W Walker Ave, Asheboro, NC 27203-6760 — (336) 633-7000

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C011328 (NC)

Record details

NPI number1952775629
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 18, 2015
Last updated in NPPESMarch 21, 2023
Certification dateMarch 21, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Avance Care Pa — 244 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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