Jataime Shadale Taylor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C019825 Issued in NC

Practice address

432 Copperfield Blvd NE
Concord, NC 28025-2426

Phone

(704) 940-2877

Fax

(704) 897-8980

NPI assigned

May 16, 2023

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1215628706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PEWTER CT",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465000",
            "telephone_number": "910-382-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 COPPERFIELD BLVD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252426",
            "telephone_number": "704-940-2877",
            "fax_number": "704-897-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JATAIME",
        "middle_name": "SHADALE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C019825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alecia Smith Taylor, LCSW-A, LCAS-A
• Alexia Taylor
• Chau Chu Taylor, MD
• Gwendolyn Shaudre Taylor
• Hollis Annette Taylor, DNP, FNP-BC
• Jerry Juergen Taylor, M.D.
• Kathryn Taylor, PT
• Kyndle Brooke Taylor
• Rogelyn Taylor
• Skyler Elle Taylor, LCSW

• 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 Jul 22, 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.