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

Nicole Shatell Mallory, LCSWA

Individual provider Clinical Social Worker · NPI 1528943875

Nicole Shatell Mallory, LCSWA is a Clinical Social Worker in Charlotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2025.

Licensed in
NC
In the registry since
2025

Practice location Address checks out

3623 Latrobe Dr Ste 119
Charlotte, NC 28211-1187
Phone: (980) 502-9615
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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 P022663 (NC)

Record details

NPI number1528943875
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSWA
Sole proprietorNo
NPI enumeratedAugust 6, 2025
Last updated in NPPESAugust 6, 2025
Certification dateAugust 6, 2025

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