Christina Shelby Boland, LCSW
Individual provider Active NPI Clinical Social Worker · Statesville, NC
NPI 1043961675 · NPPES record last updated Jan 22, 2026
Key facts
- NPI
- 1043961675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- P016000 (NC)
- Practice address
- 619 Sullivan Rd
Statesville, NC 28677-3437 - Phone
- (704) 871-0934
- Fax
- (704) 402-1065
- NPI assigned
- Jan 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Easter Seals Ucp North Carolina and Virginia, Inc.
Practice addresses (Care Compare)
619 Sullivan Rd
Statesville, NC 28677-3437
Phone (704) 871-0934
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241231000064 | NC | Practitioner - Clinical Social Worker | 7618404724 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P016000 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easter Seals Ucp North Carolina & Virginia, Inc. | Current |
Accepting new patients | |
| Easter Seals Ucp North Carolina & Virginia, Inc. | Mental Health | Current | Accepting new patients |
| Easter Seals Ucp North Carolina & Virginia, Inc. | Current |
Accepting new patients |
Locations
414 W Lebanon St
Mount Airy, NC 27030
Phone (336) 789-9041
5171 Glenwood Ave
Ste 211
Raleigh, NC 27612
Phone (919) 210-7661
619 Sullivan Rd
Statesville, NC 28677
Phone (704) 871-0934
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P016000 | NC | |
| Clinical Social Worker | 1041C0700X | P016000 | NC | Yes |
Addresses
Primary practice location
619 Sullivan Rd
Statesville, NC 28677-3437
Mailing address
619 Sullivan Rd
Statesville, NC 28677-3437
Phone (704) 871-0934
Other practice location 1
414 W Lebanon St
Mount Airy, NC 27030-2954
Phone (336) 789-9492
Other practice location 2
1874 W Old Hwy 64
Lexington, NC 27295
Phone (336) 609-3737
Other names
- Christina Shelby Nobles
Other providers in Statesville, NC
- Pedro Ariel Blanco
- Blankenship Chiropractic Clinic, PA
- Radford H Blankenship
- Nicole-Marie Blischak
- Stacey C Bohm
- Julia Duncan Bolick
- Alisha Bolton
- Melissa Bonilla
- Kay J Bontrager
- Kelly Ann Boone
All providers in Statesville, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.