Individual provider Active NPI

Emily Abernathy, MSW, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1407304074
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013786 Issued in NC
Practice address
9332 Tibble Creek Way
Charlotte, NC 28227
Phone
(980) 216-6540
NPI assigned
Sep 13, 2016
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X C013786 NC Primary

Addresses

Primary practice location

9332 Tibble Creek Way
Charlotte, NC 28227

Mailing address

9332 Tibble Creek Way
Charlotte, NC 28227-6674
Phone (980) 216-6540

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
C013786NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1407304074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9332 TIBBLE CREEK WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282276674",
            "telephone_number": "980-216-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 TIBBLE CREEK WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28227",
            "telephone_number": "980-216-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABERNATHY",
        "first_name": "EMILY",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013786",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 7, 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.

Verify at the official NPI Registry.