Individual provider Active NPI

Lakeisha Brown, LCSW, LCAS, LPCA

  • Clinical Social Worker
  • Winterville, NC
National Provider Identifier
1487199477
Registry record updated Jan 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011739 Issued in NC
Practice address
704 Alexandria LN
Winterville, NC 28590-9494
Phone
(252) 717-7782
NPI assigned
Dec 29, 2016
Last updated
Jan 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20604 NC
Professional Counselor 101YP2500X A13559 NC
Clinical Social Worker 1041C0700X C011739 NC Primary

Addresses

Primary practice location

704 Alexandria LN
Winterville, NC 28590-9494

Mailing address

704 Alexandria LN
Winterville, NC 28590-9494
Phone (252) 717-7782

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
20604NCMDAddiction (Substance Use Disorder) Counselor
A13559NCMDProfessional Counselor
C011739NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carter Clinic, PA Past Accepting new patients
Carter Clinic, P.a. PastSince Aug 25, 2019 Accepting new patients
Carter Clinic PA PastSince Mar 4, 2021 Accepting new patients
Carter Clinic, P.a. PastSince Mar 4, 2021 Accepting new patients

Organizations & group practices 4

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": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1487199477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 ALEXANDRIA LN",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909494",
            "telephone_number": "252-717-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 ALEXANDRIA LN",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909494",
            "telephone_number": "252-717-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LAKEISHA",
        "credential": "LCSW, LCAS, LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "20604",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13559",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winterville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; 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.