Active NPI
Shaquille Edwards, LCSW-A
- Clinical Social Worker
- Concord, NC
National Provider Identifier
1700542172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P023247
- Practice address
- 11 Union St S
Concord, NC 28025-5059 - Phone
- (919) 672-5005
- NPI assigned
- Nov 10, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P023247 | NC | Primary |
Addresses
Primary practice location
11 Union St S
Concord, NC 28025-5059
Mailing address
11 Union St S
Concord, NC 28025-5059
Phone (919) 672-5005
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
| License | State | Type | Specialty |
|---|---|---|---|
| P023247 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767139200000",
"number": "1700542172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 UNION ST S",
"city": "CONCORD",
"state": "NC",
"postal_code": "280255059",
"telephone_number": "919-672-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 UNION ST S",
"city": "CONCORD",
"state": "NC",
"postal_code": "280255059",
"telephone_number": "919-672-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "SHAQUILLE",
"credential": "LCSW-A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-10",
"last_updated": "2025-12-31",
"certification_date": "2025-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P023247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.