LATASHA SHAWNTAY MCILWAINE MA, MHA, LPC, LCAS
NPI 1063631331
Counselor - Professional in Charlotte, NC
About Latasha Shawntay Mcilwaine Ma, Mha, Lpc, Lcas NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LATASHA SHAWNTAY MCILWAINE MA, MHA, LPC, LCAS (NPI 1063631331) is an individual professional provider in Charlotte, North Carolina, licensed in North Carolina (6691) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Latasha Shawntay Mcilwaine Ma, Mha, Lpc, Lcas is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Latasha Mcilwaine reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Miami, FL 33130
- Reassigned Medicare billing, Arizona, Georgia, Massachusetts, North Carolina, New Hampshire, Rhode Island and Texas enrollments
- 532 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHARLOTTE, NC 28203
CHARLOTTE, NC 28203
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Latasha Mcilwaine's NPI number?
The NPI number for Latasha Mcilwaine is 1063631331. It was assigned to this individual provider in the NPPES registry on April 25, 2007.
Where is Latasha Mcilwaine located?
Latasha Mcilwaine practices at 1409 East Blvd Suite 6B, Charlotte, NC 28203. The listed phone number is (704) 340-4666.
What is Latasha Mcilwaine's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Latasha Mcilwaine enrolled in Medicare?
Yes. Latasha Mcilwaine is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Latasha Mcilwaine's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Latasha Mcilwaine reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Latasha Mcilwaine's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Latasha Mcilwaine accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of NC, Blue Cross and Blue Shield of Texas, Cigna HealthCare of Arizona, Inc and Cigna Healthcare and 3 other insurers list Latasha Mcilwaine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Latasha Mcilwaine was last updated on March 28, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Latasha Shawntay Mcilwaine, MA, MHA, LPC, LCAS · NPI 1063631331
Professional provider in Charlotte, North Carolina. Individual provider, active in the CMS NPPES registry since April 25, 2007.
## Identity
- **NPI:** 1063631331 (Entity type: Individual)
- **Enumerated:** April 25, 2007
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 6691 (North Carolina)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1409 EAST BLVD, SUITE 6B, Charlotte, NC 28203-5817
- **Phone:** (704) 340-4666 · **Fax:** (704) 969-7298
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PA (NPI 1245845932, Miami, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** March 28, 2009
- **Other identifiers:** Medicaid 6103719 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1063631331) · Data from the CMS NPPES public registry.