Charessa McIntosh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C010212 Issued in NC

Practice address

100 Westlake Rd Ste 102
Fayetteville, NC 28314-4871

Phone

(910) 224-7159

Fax

(910) 676-7334

NPI assigned

Jun 25, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Fortitude Counseling Associates, PLLC

  • Professional Counselor
  • Fayetteville, NC
  • NPI 1558804294

  Clinical

  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1972918290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WESTLAKE RD STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283144871",
            "telephone_number": "910-224-7159",
            "fax_number": "910-676-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WESTLAKE RD STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283144871",
            "telephone_number": "910-224-7159",
            "fax_number": "910-676-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "CHARESSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxine McGuire, MA, NCLPC
• Anjanette Laurice McIlwain, MD
• David Scott McIlwain, AU.D.
• Thomas Pinckney McIlwain, M.D.
• Crystal McInnis
• Megan Ophelia McIntyre
• Nickkia McIntyre, LCSWA
• Shaelyne McIntyre
• Kara Ronnessa McKay
• Kelly C. McKay

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.