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

Millicent Johnson Shadden, LCSW

Individual provider Clinical Social Worker · NPI 1336167576

Millicent Johnson Shadden, LCSW is a Clinical Social Worker in Winston Salem, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
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

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951
Phone: (336) 718-3550
Fax: (336) 277-6981
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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 C001902 (NC)

Record details

NPI number1336167576
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJuly 17, 2006
Last updated in NPPESOctober 29, 2020
Certification dateOctober 29, 2020

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