Shela Ann Williams-Stacey, LCSW, LCAS, CSI

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008636 Issued in NC

Practice address

5209 W Wendover Ave
High Point, NC 27265-9177

Phone

(336) 899-1550

NPI assigned

Jan 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shela Ann Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1679810584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 W WENDOVER AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659177",
            "telephone_number": "336-899-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-STACEY",
        "first_name": "SHELA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCAS, CSI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-27750",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELA",
            "last_name": "WILLIAMS",
            "middle_name": "ANN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Foster Wilkins
• Laura Elizabeth Wilkinson, PTA
• Garrett George Willard
• Terri I Willard, CSAC, CCJP
• Virgil Victor Willard II, MD
• Alysha G. Williams
• Benjamin Allen Williams, DDS, PA
• Breejante Jerneisha Williams, PA-C
• Daniel Nakia Williams
• Elliott Fennell Williams, MD

• Clinical Social Worker in High Point, NC
• Providers in High Point, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.