Individual provider Active NPI

Lekeshia Miltanette Lynch, LCSW-A

  • Clinical Social Worker
  • Concord, NC
National Provider Identifier
1568899706
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011079 Issued in NC
Practice address
140 Cabarrus Ave W
Concord, NC 28025-5150
Phone
(704) 918-5494
NPI assigned
Oct 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X C011079 NC Primary

Addresses

Primary practice location

140 Cabarrus Ave W
Concord, NC 28025-5150

Mailing address

4311 School House CMNS # 140
Harrisburg, NC 28075-7510
Phone (704) 699-9375

Other identifiers 2

IdentifierTypeStateIssuer
1114421310MedicaidNC
1568899706MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180416000206 SC Practitioner - Clinical Social Worker 4082972666 Reassigns benefits to 1 organization
I20180919003718 NC Practitioner - Clinical Social Worker 4082972666 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Counseling Clinical CurrentSince Jan 23, 2018 Accepting new patients
Living Well Senior Care Inc. Current Accepting new patients
The International Center for Wellness Counseling and Consulting Clinical Current Accepting new patients
Concrete Roses Life Center CurrentSince Jul 30, 2018 Accepting new patients

Locations

2040 Randolph Rd
Ste A
Charlotte, NC 28207
Phone (704) 377-1948

140 Cabarrus Ave W
Concord, NC 28025
Phone (704) 239-6321

4311 School House Cmns
Harrisburg, NC 28075
Phone (704) 436-4078

4711 Forest Dr
Ste 3
Columbia, SC 29206
Phone (646) 450-8990

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1568899706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 SCHOOL HOUSE CMNS # 140",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757510",
            "telephone_number": "704-699-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 CABARRUS AVE W",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255150",
            "telephone_number": "704-918-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "LEKESHIA",
        "middle_name": "MILTANETTE",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114421310",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568899706",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.