Active NPI
Kimberly Eileen Charlton, LCSWA
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1336807122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P016753
- Practice address
- 769 N Wendover Rd
Charlotte, NC 28211-1118 - Phone
- (704) 376-7180
- NPI assigned
- Nov 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P016753 | NC | Primary |
Addresses
Primary practice location
769 N Wendover Rd
Charlotte, NC 28211-1118
Mailing address
769 N Wendover Rd
Charlotte, NC 28211-1118
Phone (704) 376-7180
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
| License | State | Type | Specialty |
|---|---|---|---|
| P016753 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amanda K. Crowder, LCSW, PLLC | Clinical | 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": "1638230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1336807122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "769 N WENDOVER RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111118",
"telephone_number": "704-376-7180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "769 N WENDOVER RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111118",
"telephone_number": "704-376-7180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLTON",
"first_name": "KIMBERLY",
"middle_name": "EILEEN",
"credential": "LCSWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-30",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P016753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
- Charlotte-Mecklenburg Hospital Authority
- Charlotte-Mecklenburg Hospital Authority
- Charlotte-Mecklenburg Schools
- Charlotte'S Insight, Inc.
- Charlotte'S Premiere Healthcare
- Doreen Gail Charnin, LPC,NCC,CFT,MHDL
- Leia Ann Charnin, PHD, LP, HSP-P
- Maddalithirumala S Charyalu, MD
- Cody Wootten Chase, LMFTA
- Harrison Grady Chase, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.