Individual provider Active NPI

Lindsey Macconnie

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1205670940
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P020305 Issued in NC
Practice address
1909 J N Pease PL Ste 101
Charlotte, NC 28262-4509
Phone
(980) 313-3020
NPI assigned
Jun 19, 2024
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 P020305 NC Primary

Addresses

Primary practice location

1909 J N Pease PL Ste 101
Charlotte, NC 28262-4509

Mailing address

1849 Royal Gorge Ave
Charlotte, NC 28210-4688
Phone (954) 649-0204

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
P020305NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1205670940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 ROYAL GORGE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104688",
            "telephone_number": "954-649-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 J N PEASE PL STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624509",
            "telephone_number": "980-313-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCONNIE",
        "first_name": "LINDSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P020305",
            "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 Jun 19, 2024; 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.