Individual provider Active NPI

Michael Robert Zeck, LSW, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1649818436
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P013790 Issued in NC
Practice address
145 Scaleybark Rd Ste B
Charlotte, NC 28209-2682
Phone
(419) 202-3002
NPI assigned
Dec 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P013790 NC Primary

Addresses

Primary practice location

145 Scaleybark Rd Ste B
Charlotte, NC 28209-2682

Mailing address

940 Cityscape Dr
Charlotte, NC 28205
Phone (419) 202-3002

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
P013790NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1649818436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 CITYSCAPE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28205",
            "telephone_number": "419-202-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SCALEYBARK RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092682",
            "telephone_number": "419-202-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZECK",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "LSW, LCSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013790",
            "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 Dec 12, 2019; 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.