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

Mr. Michael Antoine Boulware, LCSW

Individual provider Clinical Social Worker · NPI 1619689825

Mr. Michael Antoine Boulware, LCSW is a Clinical Social Worker in Statesville, North Carolina. Qualified in 2022, 4 years ago. Practices with Integrative Wellness Solutions PLLC, a 139-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2022
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

276 Old Mocksville Rd Ste 100
Statesville, NC 28625-1951
Phone: (704) 360-3637
Fax: (980) 939-8770
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6637 Somersworth Dr, Charlotte, NC 28215-1840 — (704) 666-3280

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence P018428 (NC)

Record details

NPI number1619689825
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 19, 2022
Last updated in NPPESApril 27, 2026
Certification dateApril 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Integrative Wellness Solutions Pllc — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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