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EVOLUTION OF SELF
NPI 1255120978
Social Worker - Clinical in Greensboro, NC

Active since May 01, 2025
701 GREEN VALLEY RD STE 100, ROOM 330, GREENSBORO, NC 27408(336) 618-7697 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Evolution Of Self NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVOLUTION OF SELF (NPI 1255120978) is a healthcare organization registered as a clinical in Greensboro, North Carolina and active in the NPI registry since May 2025. The organization lists Dominique Shamberger, Owner, as its authorized official.

NPPES Registry Identity

NPI1255120978
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameEVOLUTION OF SELF
Location Address701 GREEN VALLEY RD STE 100, ROOM 330Greensboro, NC 27408-7096
Mailing Address701 Green Valley Rd Ste 100, #330Greensboro, NC 27408-7096
Phone(336) 618-7697
Organization SubpartNo
Authorized OfficialDominique ShambergerOwner · (336) 618-7697
Enumeration DateMay 1, 2025
Last NPPES UpdateNovember 19, 2025
NPPES CertifiedNovember 19, 2025
✔ NPI 1255120978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
701 GREEN VALLEY RD STE 100, Greensboro, NC 27408
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evolution Of Self is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Evolution Of Self, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dominique Shamberger, LCSW
Clinical Social Worker
NPI 1538704077
709 RIVER RIDGE RD
Danville, VA 24541
(434) 548-3910
✔ PECOS✔ Accepts Medicare40 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Evolution Of Self's NPI number?

The NPI number for Evolution Of Self is 1255120978. It was assigned to this organization in the NPPES registry on May 1, 2025.

Where is Evolution Of Self located?

Evolution Of Self is located at 701 Green Valley Rd Ste 100 Room 330, Greensboro, NC 27408. The listed phone number is (336) 618-7697.

What is Evolution Of Self's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Evolution Of Self enrolled in Medicare?

Yes. Evolution Of Self is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Evolution Of Self?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Evolution Of Self. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Evolution Of Self accept?

Health plans from Blue Cross and Blue Shield of NC list Evolution Of Self 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 Evolution Of Self was last updated on November 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.