Individual provider Active NPI

Latoya Jewelldine Conner, LCSW, LISW-CP, LCASA

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1619641867
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C017457 Issued in NC
Practice address
3623 Latrobe Dr Ste 119
Charlotte, NC 28211-1187
Phone
(980) 502-9615
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-30286 NC
Clinical Social Worker 1041C0700X 18317 SC
Clinical Social Worker 1041C0700X 34012244A IN
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X C017457 NC Primary

Addresses

Primary practice location

3623 Latrobe Dr Ste 119
Charlotte, NC 28211-1187

Mailing address

3623 Latrobe Dr
Charlotte, NC 28211-4864
Phone (980) 502-9615

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
I20250128004520 NC Practitioner - Clinical Social Worker 5698203982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8533 Wren Creek Dr
Charlotte, NC 28269-6179
Phone (980) 349-5777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-30286NCMDAddiction (Substance Use Disorder) Counselor
34012244AINMDClinical Social Worker
18317SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Focus on the Future Addiction (Substance Use Disorder) CurrentSince Aug 28, 2022 Accepting new patients
A Jewel'S Journey Therapeutic & Consulting Services PLLC Clinical CurrentSince Sep 25, 2024 Accepting new patients

Locations

3623 Latrobe Dr
Ste 119
Charlotte, NC 28211
Phone (980) 502-9615

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.

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1619641867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114864",
            "telephone_number": "980-502-9615",
            "fax_number": "704-919-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR STE 119",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111187",
            "telephone_number": "980-502-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "LATOYA",
        "middle_name": "JEWELLDINE",
        "credential": "LCSW, LISW-CP, LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-30286",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "18317",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34012244A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.