Individual provider Active NPI

Sandra Francis Rettis, LCSW

  • Clinical Social Worker
  • Concord, NC
National Provider Identifier
1033688429
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013525 Issued in NC
Practice address
11 Union St S Ste 200
Concord, NC 28025-5098
Phone
(704) 918-9741
NPI assigned
Nov 15, 2018
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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 C013525 NC Primary

Addresses

Primary practice location

11 Union St S Ste 200
Concord, NC 28025-5098

Mailing address

11 Union St S Ste 200
Concord, NC 28025-5098
Phone (704) 918-9741

Other practice location 1

2542 Scott St
Kannapolis, NC 28083-9029
Phone (704) 918-9315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210209000342 NC Practitioner - Clinical Social Worker 7719392539 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P012366NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Family Counseling Clinical CurrentSince Jan 25, 2021 Accepting new patients

Locations

11 Union St S
Ste 200
Concord, NC 28025
Phone (704) 918-9315

11 Union St S
Ste 206
Concord, NC 28025
Phone (704) 918-9741

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": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1033688429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 UNION ST S STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255098",
            "telephone_number": "704-918-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UNION ST S STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255098",
            "telephone_number": "704-918-9741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2542 Scott St",
            "address_purpose": "LOCATION",
            "city": "Kannapolis",
            "state": "NC",
            "postal_code": "280839029",
            "country_code": "US",
            "telephone_number": "704-918-9315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RETTIS",
        "first_name": "SANDRA",
        "middle_name": "FRANCIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.