Individual provider Active NPI

A'Shaunte Katrice Nicholson, LCSWA, LCASA

  • Clinical Social Worker
  • New Bern, NC
National Provider Identifier
1861149155
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P022166 Issued in NC
Practice address
1405A S Glenburnie Rd
New Bern, NC 28562-2603
Phone
(252) 638-7875
Fax
(252) 638-7586
NPI assigned
Mar 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 30827 NC
Clinical Social Worker 1041C0700X P022166 NC Primary

Addresses

Primary practice location

1405A S Glenburnie Rd
New Bern, NC 28562-2603

Mailing address

1405A S Glenburnie Rd
New Bern, NC 28562-2603
Phone (252) 638-7875

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
30827NCMDAddiction (Substance Use Disorder) Counselor
P022166NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1861149155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405A S GLENBURNIE RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622603",
            "telephone_number": "252-638-7875",
            "fax_number": "252-638-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405A S GLENBURNIE RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622603",
            "telephone_number": "252-638-7875",
            "fax_number": "252-638-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "A'SHAUNTE",
        "middle_name": "KATRICE",
        "credential": "LCSWA, LCASA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "30827",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P022166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.