Individual provider Active NPI

Lakisha Hurt

  • Clinical Social Worker
  • Cornelius, NC
National Provider Identifier
1043851991
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1041C0700X Issued in NC
Practice address
19615 Liverpool Pkwy Ste B
Cornelius, NC 28031-4075
Phone
(818) 241-6780
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Clinical Social Worker 1041C0700X 1041C0700X NC Primary

Addresses

Primary practice location

19615 Liverpool Pkwy Ste B
Cornelius, NC 28031-4075

Mailing address

1055 E Colorado Blvd Ste 560
Pasadena, CA 91106-2380
Phone (818) 241-6780

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

LicenseStateTypeSpecialty
1041C0700XNCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina's Creative Counseling, PA 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1043851991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 E COLORADO BLVD STE 560",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062380",
            "telephone_number": "818-241-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19615 LIVERPOOL PKWY STE B",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314075",
            "telephone_number": "818-241-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURT",
        "first_name": "LAKISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "1041C0700X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.

Verify at the official NPI Registry.