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

Individual provider Clinical Social Worker · NPI 1700197159

Mrs. Stephanie Anne Blackburn, LCSW is a Clinical Social Worker in Charlotte, North Carolina. Qualified in 2008, 18 years ago. Practices with Thriveworks Clinical - North Carolina PC, a 111-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
18
Licensed in
NC
In the registry since
2010
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

4412 Park Rd
Charlotte, NC 28209-3130
Phone: (980) 217-6901
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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 C007732 (NC)

Record details

NPI number1700197159
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 30, 2010
Last updated in NPPESJanuary 10, 2024
Certification dateJanuary 10, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Thriveworks Clinical - North Carolina Pc — 111 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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