Individual provider Active NPI

Shekita Renee Brown, MSW, LCSW, LISW-CP

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1427243765
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007420 Issued in NC
Practice address
8420 Medical Plaza Dr Ste 200
Charlotte, NC 28262-9759
Phone
(980) 237-5184
Fax
(888) 467-5758
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X CSW006729 GA
Clinical Social Worker 1041C0700X 9847 SC
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C007420 NC Primary

Addresses

Primary practice location

8420 Medical Plaza Dr Ste 200
Charlotte, NC 28262-9759

Mailing address

9342 Atlas Cedar Dr
Charlotte, NC 28215-7134
Phone (704) 607-0789

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
I20111011000007 NC Practitioner - Clinical Social Worker 2264604560 Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW006729GAMDClinical Social Worker
9847SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jason D Creek PastSince Jul 26, 2024 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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1427243765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9342 ATLAS CEDAR DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282157134",
            "telephone_number": "704-607-0789",
            "fax_number": "888-467-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 MEDICAL PLAZA DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629759",
            "telephone_number": "980-237-5184",
            "fax_number": "888-467-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHEKITA",
        "middle_name": "RENEE",
        "credential": "MSW, LCSW, LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006729",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9847",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.