Individual provider Active NPI

Lalanea Chastain, MPA, MSW, LCSWA

  • Clinical Social Worker
  • Davidson, NC
National Provider Identifier
1760062376
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P015955 Issued in NC
Practice address
903 Northeast Dr Ste 201
Davidson, NC 28036-7438
Phone
(704) 896-7776
NPI assigned
Apr 9, 2021
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11928 KS
Clinical Social Worker 1041C0700X P015955 NC Primary

Addresses

Primary practice location

903 Northeast Dr Ste 201
Davidson, NC 28036-7438

Mailing address

425 N Yale Ave
Wichita, KS 67208-3245
Phone (316) 821-5565

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
11928KSMDSocial Worker
P015955NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Counseling & Consulting Clinical PastSince Apr 11, 2021 Accepting new patients
Southlake Center for Self Discovery Clinical PastSince Apr 11, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1760062376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N YALE AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083245",
            "telephone_number": "316-821-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR STE 201",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367438",
            "telephone_number": "704-896-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASTAIN",
        "first_name": "LALANEA",
        "credential": "MPA, MSW, LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "11928",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.