Shaquila O'Shay Renee Brummitt, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C016077 Issued in NC

Practice address

11 Union St S Ste 200
Concord, NC 28025-5098

Phone

(704) 918-9741

Fax

(704) 270-6213

NPI assigned

Jul 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Victory Family Counseling

  • Clinical Social Worker
  • Concord, NC
  • NPI 1063000610
  NPD

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1164030433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 UNION ST S STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255098",
            "telephone_number": "704-918-9741",
            "fax_number": "704-270-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UNION ST S STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255098",
            "telephone_number": "704-918-9741",
            "fax_number": "704-270-6213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 W Franklin Blvd",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280524145",
            "country_code": "US",
            "telephone_number": "704-865-3525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUMMITT",
        "first_name": "SHAQUILA",
        "middle_name": "O'SHAY RENEE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany N Brown
• Vincent David Brown, D.C.
• Katherine Leigh Broyhill, MS, CGC
• Carlton James Bruce, DMD
• Jill McAllister Brumfield, NP
• Dakota Griffin Brunswick, PA
• Valerie Brust
• Morgan Bruton
• Bryan T. Persinger DDS PA
• Makayla Bryant, LCSWA

• Clinical Social Worker in Concord, NC
• Providers in Concord, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.