Shaverence Lawanda Outlaw, LRT/CTRS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P023427 Issued in NC

Practice address

1695 Kernersville Medical Pkwy
Kernersville, NC 27284-7159

Phone

(336) 515-5000

NPI assigned

Jan 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Reduced Barriers

  • Community/Behavioral Health Agency
  • Winston Salem, NC
  • NPI 1538839915

  Single Specialty

  NPD Authorized official
• Salisbury Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Kernersville, NC
  • NPI 1982652723
  NPD (past)

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1194356170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 KERNERSVILLE MEDICAL PKWY",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847159",
            "telephone_number": "336-515-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 KERNERSVILLE MEDICAL PKWY",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847159",
            "telephone_number": "336-515-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "SHAVERENCE",
        "middle_name": "LAWANDA",
        "name_prefix": "Ms.",
        "credential": "LRT/CTRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Recreation Therapist",
            "state": "NC",
            "license": "3879",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P023427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBRTL",
            "identifier": "3879",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTRS",
            "identifier": "80617",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ahunna Okwubunka-Anyim, MD
• Dorothy S Okyere
• Omobolawa Oreoluwa Olagoke
• Jasmine J Omondi
• Orthocarolina, PA
• Brian W Owens, CFA
• Stacy Pace
• Lucas Padulsky
• Dalya Panbehchi
• David Dillon Parks, D.C.

• Clinical Social Worker in Kernersville, NC
• Providers in Kernersville, 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 Jun 17, 2026; 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.