Healthcare Provider Details

I. General information

NPI: 1538687132
Provider Name (Legal Business Name): SHATOYA RONIQUE ATKINS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2017
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W EDEN ST
EDENTON NC
27932-1844
US

IV. Provider business mailing address

8221 SALTWOOD PL
RALEIGH NC
27617-8728
US

V. Phone/Fax

Practice location:
  • Phone: 252-482-2186
  • Fax:
Mailing address:
  • Phone: 984-789-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC012699
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: