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NPI Code Detail

MEDICARE: NASIR I RANDOLPH-POWELL MSW, LCSWA

MEDICARE: NASIR I RANDOLPH-POWELL MSW, LCSWA
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 WorkerP022914NC

General Provider Information

NPI Number : 1841088507
Entity Type Code : Individual
Provider Name (Legal Business Name) : NASIR I RANDOLPH-POWELL MSW, LCSWA
Provider Business Mailing Address
First Line : 574 TROTTERS LN
Second Line :
City : MONCKS CORNER
State : SC
Zip : 29461-6740
Country : US
Telephone Number : 609-576-8382
Fax Number :
Provider Business Practice Location Address
First Line : 301 MCCULLOUGH DR STE 520
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-1336
Country : US
Telephone Number : 980-286-4943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2025
Last Update Date : 04/19/2026

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