Active NPI
Letitia Mouzon
- Social Worker
- Charlotte, NC
National Provider Identifier
1467809442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- P010404
- Practice address
- 5501 Executive Center Dr
Suite 238
Charlotte, NC 28212-8866 - Phone
- (980) 613-8312
- Fax
- (888) 972-4998
- NPI assigned
- May 19, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | P010404 | NC | Primary |
| Clinical Social Worker | 1041C0700X | P010404 | NC |
Addresses
Primary practice location
5501 Executive Center Dr
Suite 238
Charlotte, NC 28212-8866
Mailing address
4644 Meadowfield Rd
Charlotte, NC 28215-7809
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 |
|---|---|---|---|
| P010404 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soul Care, PLLC | Clinical | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486598400000",
"number": "1467809442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4644 MEADOWFIELD RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282157809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 EXECUTIVE CENTER DR",
"address_2": "SUITE 238",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282128866",
"telephone_number": "980-613-8312",
"fax_number": "888-972-4998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUZON",
"first_name": "LETITIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-19",
"last_updated": "2017-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NC",
"license": "P010404",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P010404",
"primary": false
}
],
"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 Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.