Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Katelyn Brooke Medina, LCSW

Individual provider Clinical Social Worker · NPI 1063011153

Katelyn Brooke Medina, LCSW is a Clinical Social Worker in Charlotte, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2020
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

5200 Park Rd Ste 218B
Charlotte, NC 28209-3650
Phone: (866) 700-1606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C015751 (NC)

Record details

NPI number1063011153
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedOctober 20, 2020
Last updated in NPPESMay 17, 2023
Certification dateMay 17, 2023

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