Individual provider Active NPI

Shayla T. Stewart, LISW-CP, LCSW, MPA

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1104424399
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013864 Issued in NC
Practice address
3205 Freedom Dr Ste 2000
Charlotte, NC 28208-3486
Phone
(704) 975-7343
NPI assigned
Oct 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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 10969 SC
Clinical Social Worker 1041C0700X C013864 NC Primary

Addresses

Primary practice location

3205 Freedom Dr Ste 2000
Charlotte, NC 28208-3486

Mailing address

2267 Eden Ter Apt 202
Rock Hill, SC 29730-2818
Phone (706) 877-0357

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
C013864NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Skycare Services LLC PastSince Oct 1, 2020 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": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1104424399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2267 EDEN TER APT 202",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297302818",
            "telephone_number": "706-877-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 FREEDOM DR STE 2000",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083486",
            "telephone_number": "704-975-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SHAYLA",
        "middle_name": "T.",
        "credential": "LISW-CP, LCSW, MPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10969",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.