Individual provider Active NPI

Keya Lachelle Glover, LCSW

  • Clinical Social Worker
  • Winston Salem, NC
National Provider Identifier
1184990764
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006642 Issued in NC
Practice address
140 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6185
Phone
(336) 718-7250
NPI assigned
Mar 28, 2012
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 C006642 NC Primary

Addresses

Primary practice location

140 Kimel Park Dr Ste 200
Winston Salem, NC 27103-6185

Mailing address

PO Box 604281
Charlotte, NC 28260-4281

Other practice location 1

725 Highland Ave
Winston Salem, NC 27101-4206
Phone (336) 607-8523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1184990764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604281",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 KIMEL PARK DR STE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036185",
            "telephone_number": "336-718-7250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271014206",
            "country_code": "US",
            "telephone_number": "336-607-8523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "KEYA",
        "middle_name": "LACHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.