Lalanea Chastain, MPA, MSW, LCSWA

Individual provider Active NPI Clinical Social Worker · Davidson, NC

NPI 1760062376 · NPPES record last updated Apr 9, 2021

Key facts

NPI
1760062376
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
P015955 (NC)
Practice address
903 Northeast Dr Ste 201
Davidson, NC 28036-7438
Phone
(704) 896-7776
NPI assigned
Apr 9, 2021
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11928KSMDSocial Worker
P015955NCMDClinical Social Worker

Practice roles

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

Specialties & licenses

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

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

Other providers in Davidson, NC

All providers in Davidson, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.