Individual provider Active NPI

Laquetta Evans, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1376196998
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C018480 Issued in NC
Practice address
10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513
Phone
(704) 360-3637
NPI assigned
Jul 23, 2019
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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 P0139896 NC
Clinical Social Worker 1041C0700X C018480 NC Primary

Addresses

Primary practice location

10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513

Mailing address

10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513
Phone (704) 360-3637

Other practice location 1

122 Gateway Blvd Ste C
Mooresville, NC 28117-5544
Phone (704) 360-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200319000862 NC Practitioner - Clinical Social Worker 1557799889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

10430 Harris Oak Blvd
Suite L
Charlotte, NC 28269-7513
Phone (704) 317-2930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C018480NCMDClinical Social Worker
P0139896NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Wellness Solutions, PLLC Clinical CurrentSince May 5, 2025 Accepting new patients
Asheli Thompson PastSince Jun 23, 2015 Accepting new patients

Locations

10430 Harris Oak Blvd
Ste L
Charlotte, NC 28269
Phone (704) 317-2930

3625 N Elm St
Ste 130
Greensboro, NC 27455

9525 Birkdale Crossing Dr
Ste 300
Huntersville, NC 28078
Phone (704) 317-2930

122 Gateway Blvd
Ste C
Mooresville, NC 28117
Phone (980) 766-1030

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1376196998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10430 HARRIS OAK BLVD STE L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697513",
            "telephone_number": "704-360-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10430 HARRIS OAK BLVD STE L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697513",
            "telephone_number": "704-360-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Gateway Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281175544",
            "country_code": "US",
            "telephone_number": "704-360-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LAQUETTA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P0139896",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C018480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.