Individual provider · Type 1 NPI

Michael Antoine Boulware, LCSW

Clinical Social Worker · Statesville, NC

NPI number 1619689825 Active

Practice location

276 Old Mocksville Rd Ste 100
Statesville, NC 28625-1951

Call (704) 360-3637 Map

Fax (980) 939-8770

Other practice locations

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

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XP018428 (NC)

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…

8 other providers at this address

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About NPI 1619689825

Michael Antoine Boulware, LCSW's National Provider Identifier is 1619689825, issued on Dec 19, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Statesville, NC. The record was last updated on Apr 27, 2026.