Individual provider Active NPI

Lekeesha Lequan Charles, LCSW

  • Clinical Social Worker
  • Lancaster, TX
National Provider Identifier
1013412774
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
40801 Issued in TX
Practice address
1941 Day Break Dr
Lancaster, TX 75146-4949
Phone
(469) 243-8879
NPI assigned
Mar 26, 2018
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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 40801 TX Primary

Addresses

Primary practice location

1941 Day Break Dr
Lancaster, TX 75146-4949

Mailing address

PO Box 191591
Dallas, TX 75219-8502
Phone (972) 415-5177

Other names 1

  • Lakeesha Lequan Charles Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20180625003457 TX Practitioner - Clinical Social Worker 3476808973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1941 Day Break Dr
Lancaster, TX 75146-4949
Phone (469) 243-8879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40801TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Community Counseling Center PLLC Clinical CurrentSince Mar 5, 2018 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1013412774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191591",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752198502",
            "telephone_number": "972-415-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 DAY BREAK DR",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751464949",
            "telephone_number": "469-243-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "LEKEESHA",
        "middle_name": "LEQUAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "40801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAKEESHA",
            "last_name": "CHARLES",
            "middle_name": "LEQUAN",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lancaster, TX

Sources for this page

Verify at the official NPI Registry.