Provider Demographics
NPI:1689963944
Name:SPEARS, DESHAWN CELESTE (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:DESHAWN
Middle Name:CELESTE
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10640 GLENMAC RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8016
Mailing Address - Country:US
Mailing Address - Phone:704-258-3350
Mailing Address - Fax:
Practice Address - Street 1:615 E 6TH ST STE 111
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2918
Practice Address - Country:US
Practice Address - Phone:704-780-6066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0071921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical