Individual provider Active NPI

Shequanta Latroya Parker, LCSW-A

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1235570581
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P021752 Issued in NC
Practice address
2443 Lynn Rd Ste 112
Raleigh, NC 27612-6759
Phone
(919) 438-4060
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P008228 NC
Clinical Social Worker 1041C0700X P021752 NC Primary

Addresses

Primary practice location

2443 Lynn Rd Ste 112
Raleigh, NC 27612-6759

Mailing address

8631 Neuse Club LN Apt 107
Raleigh, NC 27616-8039
Phone (252) 916-1389

Other practice location 1

1205 Maple Ave
Burlington, NC 27215-6958
Phone (336) 514-9493

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
P008228NCMDMental Health Counselor
P021752NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Legacy Mental Health Services, Inc Past 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": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1235570581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 NEUSE CLUB LN APT 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168039",
            "telephone_number": "252-916-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 LYNN RD STE 112",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126759",
            "telephone_number": "919-438-4060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "272156958",
            "country_code": "US",
            "telephone_number": "336-514-9493",
            "fax_number": "336-395-8501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "SHEQUANTA",
        "middle_name": "LATROYA",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P008228",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P021752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.