Individual provider Active NPI

David Shein, LCSW, CADC

  • Clinical Social Worker
  • Huntersville, NC
National Provider Identifier
1083183255
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C01348 Issued in NC
Practice address
9723 Northcross Center CT Ste J
Huntersville, NC 28078-7301
Phone
(312) 519-1180
NPI assigned
Nov 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.020414 IL
Clinical Social Worker 1041C0700X C01348 NC Primary

Addresses

Primary practice location

9723 Northcross Center CT Ste J
Huntersville, NC 28078-7301

Mailing address

5110 Washam Green LN
Cornelius, NC 28031-0450
Phone (312) 519-1180

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
149.020414ILMDClinical Social Worker
C01348NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1542412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1083183255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 WASHAM GREEN LN",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280310450",
            "telephone_number": "312-519-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9723 NORTHCROSS CENTER CT STE J",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787301",
            "telephone_number": "312-519-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEIN",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-17",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020414",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C01348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.