GLEN ALLEN DERRA
NPI 1780534834
Social Worker - Clinical in Sanford, NC

Active since January 29, 2026
130 CARBONTON RD, SANFORD, NC 27330(919) 774-6521 Get Directions Write a Review

NPPES record last updated: January 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Glen Allen Derra NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLEN ALLEN DERRA (NPI 1780534834) is an individual clinical provider in Sanford, North Carolina, licensed in North Carolina (P023351) and active in the NPI registry since January 2026.

NPPES Registry Identity

NPI1780534834
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameGLEN ALLEN DERRA
Location Address130 CARBONTON RDSanford, NC 27330-4009
Mailing Address284 Executive Park Dr Ste 100Concord, NC 28025-1833 · (704) 939-1100 · Fax (704) 939-1173
Sole ProprietorNo
Enumeration DateJanuary 29, 2026
NPPES CertifiedJanuary 29, 2026
NPI 1780534834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in NC · P023351
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
130 CARBONTON RD, Sanford, NC 27330

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
130 CARBONTON RD
SANFORD, NC 27330
Social Worker (Clinical)
130 CARBONTON RD
SANFORD, NC 27330
Counselor (Addiction (Substance Use Disorder))
130 CARBONTON RD
SANFORD, NC 27330
Counselor (Professional)
130 CARBONTON RD
SANFORD, NC 27330
Counselor
130 CARBONTON RD
SANFORD, NC 27330
Marriage & Family Therapist
130 CARBONTON RD
SANFORD, NC 27330
Social Worker (Clinical)
130 CARBONTON RD
SANFORD, NC 27330
Social Worker (Clinical)
130 CARBONTON RD
SANFORD, NC 27330

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Derra's NPI number?

The NPI number for Glen Derra is 1780534834. It was assigned to this individual provider in the NPPES registry on January 29, 2026.

Where is Glen Derra located?

Glen Derra practices at 130 Carbonton Rd, Sanford, NC 27330. The listed phone number is (919) 774-6521.

What is Glen Derra's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Glen Derra was last updated on January 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.