Individual provider Active NPI

Shaylyn Renee' Jones, LCSW,MHP

  • Clinical Social Worker
  • Southern Pines, NC
National Provider Identifier
1336790047
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015908 Issued in NC
Practice address
105 E Massachusetts Ave
Southern Pines, NC 28387-6131
Phone
(910) 585-6364
Fax
(253) 584-1496
NPI assigned
Sep 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C015908 NC Primary
Clinical Social Worker 1041C0700X SC60988973 WA

Addresses

Primary practice location

105 E Massachusetts Ave
Southern Pines, NC 28387-6131

Mailing address

4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010
Phone (910) 585-6364

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
C015908NCMDClinical Social Worker
SC60988973WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1336790047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 349",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010",
            "telephone_number": "910-585-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E MASSACHUSETTS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283876131",
            "telephone_number": "910-585-6364",
            "fax_number": "253-584-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SHAYLYN",
        "middle_name": "RENEE'",
        "credential": "LCSW,MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015908",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60988973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.