Avery Blackwell, MSW, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C015629 Issued in NC

Practice address

68 Stewart Town Rd
Lillington, NC 27546-6398

Phone

(910) 929-2103

NPI assigned

Oct 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Drayton'S View Therapy and Wellness Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lillington, NC
  • NPI 1457237737
  NPD
• Anderson Counseling and Consulting Group, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1629416029

  Clinical

  NPD (past)

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1891205928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4861 PINNACLE DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 STEWART TOWN RD",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275466398",
            "telephone_number": "910-929-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "AVERY",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891205928",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfunderburk@acounseling.net",
            "affiliation": "N",
            "endpointDescription": "HR Manager",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HR Manager",
            "address_1": "8401 Medical Plaza Dr Ste 360",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282628700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Justin Bentley
• Matthew Berg, LCMHC-A
• Meghana Ganapati Bhat, DMD
• Daisy May Black, SLP
• Cheyenne Blackshear, B.A., HHP
• Allison Rebekah Blaylock
• Blessed Sales Group LLC
• Meagan M. Blews
• Alexis Densie Blue-Wilson
• BN Healthcare, LLC

• All providers in Lillington, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.