Individual provider Active NPI

Gladys J. Mannas-Stevens, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1952419780
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004710 Issued in NC
Practice address
4822 Albemarle Rd
Suite 112
Charlotte, NC 28205-6668
Phone
(704) 562-7657
Fax
(704) 947-2278
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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 C004710 NC Primary

Addresses

Primary practice location

4822 Albemarle Rd
Suite 112
Charlotte, NC 28205-6668

Mailing address

5817 Coopers Ridge LN
PH
Charlotte, NC 28269-1032
Phone (704) 562-7657

Other identifiers 1

IdentifierTypeStateIssuer
6003723MedicaidNC

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
C004710NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
S.T.E.P's Developmental Academy, Inc. CurrentSince Jan 20, 2013 Accepting new patients
Gladys J Mannas-Stevens Clinical PastSince Jan 1, 1990 Accepting new patients

Locations

4822 Albemarle Rd
Ste 112
Charlotte, NC 28205
Phone (704) 532-5757

4822 Albemarle Rd
#112B
Charlotte, NC 28205
Phone (704) 532-5757

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1952419780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5817 COOPERS RIDGE LN",
            "address_2": "PH",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691032",
            "telephone_number": "704-562-7657",
            "fax_number": "704-947-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4822 ALBEMARLE RD",
            "address_2": "SUITE 112",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056668",
            "telephone_number": "704-562-7657",
            "fax_number": "704-947-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNAS-STEVENS",
        "first_name": "GLADYS",
        "middle_name": "J.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003723",
            "state": "NC"
        }
    ],
    "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 Apr 24, 2013; 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.