Active NPI
William Trent Haben, LCSW
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1861036113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C013756
- Practice address
- 4412 Park Rd Ste B
Charlotte, NC 28209-3130 - Phone
- (855) 675-4144
- Fax
- (617) 807-0958
- NPI assigned
- Oct 30, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.021245 | IL | |
| Clinical Social Worker | 1041C0700X | C013756 | NC | Primary |
Addresses
Primary practice location
4412 Park Rd Ste B
Charlotte, NC 28209-3130
Mailing address
259 E Erie Street
19TH Floor, Suite 1900
Chicago, IL 60611
Phone (312) 695-7950
Other practice location 1
259 E Erie Street
19th floor, Suite 1900
Chicago, IL 60611
Phone (312) 695-7950
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.021245 | IL | MD | Clinical Social Worker |
| C013756 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743120000000",
"number": "1861036113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E ERIE STREET",
"address_2": "19TH FLOOR, SUITE 1900",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-695-7950",
"fax_number": "312-695-5747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4412 PARK RD STE B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093130",
"telephone_number": "855-675-4144",
"fax_number": "617-807-0958"
}
],
"practiceLocations": [
{
"address_1": "259 E Erie Street",
"address_2": "19th floor, Suite 1900",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60611",
"country_code": "US",
"telephone_number": "312-695-7950",
"fax_number": "312-695-5747",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HABEN",
"first_name": "WILLIAM",
"middle_name": "TRENT",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-30",
"last_updated": "2025-03-28",
"certification_date": "2025-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.021245",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C013756",
"primary": true
}
],
"identifiers": [],
"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 Mar 28, 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.