Individual provider Active NPI

Shikinda Danielle Gethers, LCSW-A

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1689507428
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P023665 Issued in NC
Practice address
9628 Pond Vista CT
Charlotte, NC 28216-6834
Phone
(843) 224-6125
Fax
(704) 569-0822
NPI assigned
Jun 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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 P023665 NC Primary

Addresses

Primary practice location

9628 Pond Vista CT
Charlotte, NC 28216-6834

Mailing address

9628 Pond Vista CT
Charlotte, NC 28216-6834
Phone (843) 224-6125

Other practice location 1

5601 Executive Center Dr Ste 200
Charlotte, NC 28212-8841
Phone (704) 537-1022

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
P023665NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1689507428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9628 POND VISTA CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282166834",
            "telephone_number": "843-224-6125",
            "fax_number": "704-569-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9628 POND VISTA CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282166834",
            "telephone_number": "843-224-6125",
            "fax_number": "704-569-0822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 Executive Center Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282128841",
            "country_code": "US",
            "telephone_number": "704-537-1022",
            "fax_number": "704-569-0822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GETHERS",
        "first_name": "SHIKINDA",
        "middle_name": "DANIELLE",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P023665",
            "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 Jun 10, 2026; 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.