Individual provider Active NPI

Shakeda Muldrow, LCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1760907646
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C018697 Issued in NC
Practice address
5109 Hollyridge Dr
Raleigh, NC 27612-3146
Phone
(336) 312-4766
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 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 C018697 NC Primary

Addresses

Primary practice location

5109 Hollyridge Dr
Raleigh, NC 27612-3146

Mailing address

3064 Wake Forest Rd # 1180
Raleigh, NC 27609-7844
Phone (919) 948-0105

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
C018697NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Safe Space Therapeutic Services, PLLC Clinical Current Accepting new patients

Locations

3064 Wake Forest Rd
Raleigh, NC 27609
Phone (415) 360-3349

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1760907646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3064 WAKE FOREST RD # 1180",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097844",
            "telephone_number": "919-948-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 HOLLYRIDGE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123146",
            "telephone_number": "336-312-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDROW",
        "first_name": "SHAKEDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C018697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.