Active NPI
Aishah Renee Whitehead, LCSWA
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1619468501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P011394
- Practice address
- 5200 Park Rd Ste 218B
Charlotte, NC 28209-3650 - Phone
- (866) 700-1606
- Fax
- (866) 338-5921
- NPI assigned
- May 25, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P011394 | NC | Primary |
Addresses
Primary practice location
5200 Park Rd Ste 218B
Charlotte, NC 28209-3650
Mailing address
419 Tyler Trail CT Apt 222
Charlotte, NC 28262-3393
Phone (770) 895-7580
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P011394 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Season of Change, PLLC | Clinical | Current | Accepting new patients |
| Sparc Network | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Charlotte, NC
- NPI 1538767785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527206400000",
"number": "1619468501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 TYLER TRAIL CT APT 222",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282623393",
"telephone_number": "770-895-7580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 PARK RD STE 218B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093650",
"telephone_number": "866-700-1606",
"fax_number": "866-338-5921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHEAD",
"first_name": "AISHAH",
"middle_name": "RENEE",
"credential": "LCSWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2018-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P011394",
"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 May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.