Active NPI
Vicki Kamille Witcher, LCSWA
- Clinical Social Worker
- Conover, NC
National Provider Identifier
1033977640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PO15754
- Practice address
- 6347 St Peters Church Rd
Conover, NC 28613-8862 - Phone
- (704) 827-3788
- NPI assigned
- Mar 8, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | PO15754 | NC | Primary |
Addresses
Primary practice location
6347 St Peters Church Rd
Conover, NC 28613-8862
Mailing address
2226 Taras Trace Dr
Statesville, NC 28625-8296
Phone (336) 965-0802
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO15754 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shining Hope Farms | Clinical | Past | 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": "1709856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709856000000",
"number": "1033977640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2226 TARAS TRACE DR",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286258296",
"telephone_number": "336-965-0802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6347 ST PETERS CHURCH RD",
"city": "CONOVER",
"state": "NC",
"postal_code": "286138862",
"telephone_number": "704-827-3788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITCHER",
"first_name": "VICKI",
"middle_name": "KAMILLE",
"credential": "LCSWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-08",
"last_updated": "2024-03-08",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "PO15754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conover, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.