Individual provider Active NPI

Juliet Meredith Nyborg

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1922814565
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P021485 Issued in NC
Practice address
501 Billingsley Rd
Charlotte, NC 28211-1009
Phone
(704) 444-2400
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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 P021485 NC Primary

Addresses

Primary practice location

501 Billingsley Rd
Charlotte, NC 28211-1009

Mailing address

210 Alpha Mill LN Apt 120
Charlotte, NC 28206-3312
Phone (914) 943-8184

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
P021485NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1922814565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ALPHA MILL LN APT 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282063312",
            "telephone_number": "914-943-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BILLINGSLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-444-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBORG",
        "first_name": "JULIET",
        "middle_name": "MEREDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P021485",
            "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 Jul 14, 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.