Healthcare Provider Details

I. General information

NPI: 1205144060
Provider Name (Legal Business Name): SHARIYFA AZIYZA POLITE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7821 CHEAHA DR
RALEIGH NC
27616-2215
US

IV. Provider business mailing address

7821 CHEAHA DR APT 202
RALEIGH NC
27616-2217
US

V. Phone/Fax

Practice location:
  • Phone: 432-309-4336
  • Fax: 844-691-3116
Mailing address:
  • Phone: 432-309-4336
  • Fax: 844-691-3116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC015718
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: