Active NPI
Avianna Jhane Marcelin
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1033894613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 3506 W Tyvola Rd
Charlotte, NC 28208-7201 - Phone
- (704) 329-1300
- NPI assigned
- Jun 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
3506 W Tyvola Rd
Charlotte, NC 28208-7201
Mailing address
5830 Sanders Farm LN
Charlotte, NC 28216-1550
Phone (704) 804-6960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781222400000",
"number": "1033894613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5830 SANDERS FARM LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282161550",
"telephone_number": "704-804-6960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3506 W TYVOLA RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282087201",
"telephone_number": "704-329-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCELIN",
"first_name": "AVIANNA",
"middle_name": "JHANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-20",
"last_updated": "2026-06-12",
"certification_date": "2026-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.