Active NPI
Vanessa Maria Hawkins Staton, MA LPA
- Psychologist
- Charlotte, NC
National Provider Identifier
1356366967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1079
- Practice address
- 6809 Fairview Rd
Charlotte, NC 28210-4195 - Phone
- (704) 364-1106
- Fax
- (866) 210-4848
- NPI assigned
- Jul 13, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1079 | NC | Primary |
Addresses
Primary practice location
6809 Fairview Rd
Charlotte, NC 28210-4195
Mailing address
6809 Fairview Rd
Charlotte, NC 28210-4195
Phone (704) 364-1106
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4364854 | Other | NC | NC |
| 135WW | Other | NC | BCBS |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1079 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747612800000",
"number": "1356366967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6809 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282104195",
"telephone_number": "704-364-1106",
"fax_number": "866-210-4848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6809 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282104195",
"telephone_number": "704-364-1106",
"fax_number": "866-210-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STATON",
"first_name": "VANESSA",
"middle_name": "MARIA HAWKINS",
"name_prefix": "Ms.",
"credential": "MA LPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2025-05-19",
"certification_date": "2025-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC",
"identifier": "4364854",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "135WW",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.