Active NPI
Kanathia Valaya Brown-Narcisse, LCSWA
- Clinical Social Worker
- Mint Hill, NC
National Provider Identifier
1356168397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P021024
- Practice address
- 10505 Clear Creek Commerce
Mint Hill, NC 28227 - Phone
- (980) 344-0409
- NPI assigned
- Sep 23, 2024
- 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 | P021024 | NC | Primary |
Addresses
Primary practice location
10505 Clear Creek Commerce
Mint Hill, NC 28227
Mailing address
11822 Silvercrest Dr
Charlotte, NC 28215-9903
Phone (704) 430-7713
Other practice location 1
11822 Silvercrest Dr
Charlotte, NC 28215-9903
Phone (704) 773-5715
Other practice location 2
3705 Latrobe Drive Suite 340
Charlotte, NC 28211
Phone (704) 364-3989
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 |
|---|---|---|---|
| P021024 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peaceful Solution Counseling 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.
-
- Community/Behavioral Health Agency
- Charlotte, NC
- NPI 1104231273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1356168397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11822 SILVERCREST DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282159903",
"telephone_number": "704-430-7713",
"fax_number": "704-573-4314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10505 CLEAR CREEK COMMERCE",
"city": "MINT HILL",
"state": "NC",
"postal_code": "28227",
"telephone_number": "980-344-0409"
}
],
"practiceLocations": [
{
"address_1": "11822 Silvercrest Dr",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282159903",
"country_code": "US",
"telephone_number": "704-773-5715",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3705 Latrobe Drive Suite 340",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "28211",
"country_code": "US",
"telephone_number": "704-364-3989",
"fax_number": "704-364-3974",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN-NARCISSE",
"first_name": "KANATHIA",
"middle_name": "VALAYA",
"credential": "LCSWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-23",
"last_updated": "2024-09-23",
"certification_date": "2024-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P021024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mint Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.