Individual provider Active NPI

Emily Joyce Materdo, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1104265321
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C017661 Issued in NC
Practice address
6324 Fairview Rd Ste 460
Charlotte, NC 28210-3374
Phone
(980) 302-8611
NPI assigned
Jun 20, 2013
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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 C017661 NC Primary
Clinical Social Worker 1041C0700X 043713348 NC

Addresses

Primary practice location

6324 Fairview Rd Ste 460
Charlotte, NC 28210-3374

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (980) 302-8611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111002854 NC Practitioner - Clinical Social Worker 9234663436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chronic Health Counseling PLLCGroup PAC ID 1850644501, 3 clinicians

Practice addresses (Care Compare)

845 Church St N
Suite 208 3
Concord, NC 28025-4300
Phone (704) 517-2106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043713348NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chronic Health Counseling, PLLC Clinical CurrentSince Oct 10, 2024 Accepting new patients

Locations

845 Church St N
Ste 2083
Concord, NC 28025
Phone (704) 517-2106

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": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1104265321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "980-302-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 460",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103374",
            "telephone_number": "980-302-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATERDO",
        "first_name": "EMILY",
        "middle_name": "JOYCE",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017661",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "043713348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.