Active NPI
Shanita Mitchell Parker, MSW, LCSW
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1730834532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C012164
- Practice address
- 10932 Tavernay Pkwy
Charlotte, NC 28262-4435 - Phone
- (703) 399-5146
- NPI assigned
- Feb 21, 2022
- Last updated
- Feb 21, 2022
- Sex
- Female
- 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 | C012164 | NC | Primary |
Addresses
Primary practice location
10932 Tavernay Pkwy
Charlotte, NC 28262-4435
Mailing address
10932 Tavernay Pkwy
Charlotte, NC 28262-4435
Phone (703) 399-5146
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C012164 | Medicaid | NC | |
| C012164 | Other | NC | LCSW |
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 |
|---|---|---|---|
| C012164 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Connections of the Carolinas | Clinical | Current | Accepting new patients |
| Healing Pathways | Clinical | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Charlotte, NC
- NPI 1639827884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645401600000",
"number": "1730834532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10932 TAVERNAY PKWY",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282624435",
"telephone_number": "703-399-5146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10932 TAVERNAY PKWY",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282624435",
"telephone_number": "703-399-5146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "SHANITA",
"middle_name": "MITCHELL",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-21",
"last_updated": "2022-02-21",
"certification_date": "2022-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C012164",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "C012164",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "C012164",
"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 Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.