Individual provider · Type 1 NPI

La'draya Shamicka Macon, LCSW, CASAC

Clinical Social Worker · Roosevelt, NY

NPI number 1497020440 Active

Practice location

27A Washington Pl
Roosevelt, NY 11575-1454

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X083947 (NY)
Social Worker 104100000X086013 (NY)
Addiction (Substance Use Disorder) Counselor 101YA0400X31869 (NY)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1497020440

La'draya Shamicka Macon, LCSW, CASAC's National Provider Identifier is 1497020440, issued on Mar 8, 2012. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Roosevelt, NY. The record was last updated on May 4, 2016.