Individual provider Active NPI

Kwanza Suzanne Winn, LMSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1184224727
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015539 Issued in NC
Practice address
2510 Hope Way LN
Charlotte, NC 28262-6954
Phone
(704) 710-6495
NPI assigned
Oct 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C015539 NC Primary

Addresses

Primary practice location

2510 Hope Way LN
Charlotte, NC 28262-6954

Mailing address

9805 Statesville Rd Ste 6486
Charlotte, NC 28269-7647
Phone (704) 710-6495

Other practice location 1

5200 Park Rd Ste 218B
Charlotte, NC 28209-3650
Phone (866) 700-1606

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
C015539NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sparc Network Clinical PastSince Nov 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": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1184224727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9805 STATESVILLE RD STE 6486",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697647",
            "telephone_number": "704-710-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 HOPE WAY LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282626954",
            "telephone_number": "704-710-6495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Park Rd Ste 218B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282093650",
            "country_code": "US",
            "telephone_number": "866-700-1606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINN",
        "first_name": "KWANZA",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015539",
            "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 Dec 21, 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.