MEDICARE: SUMMER MENDEZ 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
1	1041C0700X	Clinical Social Worker	P017025	NC

General Provider Information

NPI Number	:	1588322135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMMER MENDEZ MSW, LCSW

Provider Business Mailing Address
First Line	:	11220 TREYNORTH DR STE A
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-8198
Country	:	US
Telephone Number	:	980-272-0157
Fax Number	:

Provider Business Practice Location Address
First Line	:	11220 TREYNORTH DR STE A
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-8198
Country	:	US
Telephone Number	:	980-272-0157
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2021
Last Update Date	:	11/20/2025

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