Individual provider Active NPI

William Trent Haben, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1861036113
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013756 Issued in NC
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

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
149.021245ILMDClinical Social Worker
C013756NCMDClinical 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.

Verify at the official NPI Registry.