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NPI Code Detail

MEDICARE: SHAQUIL RASHEED ROBERTS MSW, LCSW

MEDICARE: SHAQUIL RASHEED ROBERTS MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC018558NC

General Provider Information

NPI Number : 1447991393
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAQUIL RASHEED ROBERTS MSW, LCSW
Provider Business Mailing Address
First Line : 10130 MALLARD CREEK RD STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-6001
Country : US
Telephone Number : 980-272-8167
Fax Number :
Provider Business Practice Location Address
First Line : 10130 MALLARD CREEK RD STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-6001
Country : US
Telephone Number : 980-272-8167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2022
Last Update Date : 02/24/2026

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