Zaria Davis Humphries, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Charlotte, NC
NPI 1295029908 · NPPES record last updated May 31, 2011
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jul 20, 2016.
Key facts
- NPI
- 1295029908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C006469 (NC)
- Practice address
- 6611 Allness Glen LN
Charlotte, NC 28269-6913 - Phone
- (704) 380-1313
- NPI assigned
- May 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.0800078 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Impact Solutions, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9117 | SC | |
| Clinical Social Worker | 1041C0700X | C006469 | NC | Yes |
| Clinical Social Worker | 1041C0700X | I.0800078 | OH |
Addresses
Primary practice location
6611 Allness Glen LN
Charlotte, NC 28269-6913
Mailing address
6611 Allness Glen LN
Charlotte, NC 28269-6913
Phone (704) 380-1313
Other providers in Charlotte, NC
- Alana Gail Humphries
- Charles Thomas Humphries
- Michael Smith Humphries
- Nakela Humphries
- Virginia Humphries
- Eric Bernard Hun Ter
- Amy D. Huneycutt
- Kelley Ann Huneycutt
- Savannah Huneycutt
- Sherri F Huneycutt
All providers in Charlotte, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.