Individual provider Active NPI

Shereka Dabney, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1629696125
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P014800 Issued in NC
Practice address
1101 Sunset Rd Unit 681556
Charlotte, NC 28216-0468
Phone
(980) 495-6305
Fax
(980) 495-6535
NPI assigned
Jul 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention Professional 405300000X P014800 NC
Clinical Social Worker 1041C0700X P014800 NC Primary

Addresses

Primary practice location

1101 Sunset Rd Unit 681556
Charlotte, NC 28216-0468

Mailing address

1101 Sunset Rd Unit 681556
Charlotte, NC 28216-0468
Phone (980) 495-6305

Other identifiers 1

IdentifierTypeStateIssuer
1629696125MedicaidNC

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
P014800NCMDPrevention Professional

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1629696125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SUNSET RD UNIT 681556",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282160468",
            "telephone_number": "980-495-6305",
            "fax_number": "980-495-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SUNSET RD UNIT 681556",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282160468",
            "telephone_number": "980-495-6305",
            "fax_number": "980-495-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABNEY",
        "first_name": "SHEREKA",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2021-05-19",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "NC",
            "license": "P014800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629696125",
            "state": "NC"
        }
    ],
    "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 19, 2021; 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.