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MILLICENT JOHNSON SHADDEN LCSW
NPI 1336167576
Social Worker - Clinical in Winston Salem, NC

Active since July 17, 2006PECOS Enrolled
175 KIMEL PARK DR STE 100, WINSTON SALEM, NC 27103(336) 718-3550(336) 277-6981 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Millicent Johnson Shadden Lcsw NPPES

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

MILLICENT JOHNSON SHADDEN LCSW (NPI 1336167576) is an individual clinical provider in Winston Salem, North Carolina, licensed in North Carolina (C001902) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336167576
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMILLICENT JOHNSON SHADDENCredential: LCSW
Location Address175 KIMEL PARK DR STE 100Winston Salem, NC 27103-6951
Mailing AddressPo Box 751803Charlotte, NC 28275-1803
Phone(336) 718-3550
Fax(336) 277-6981
Sole ProprietorNo
Enumeration DateJuly 17, 2006
Last NPPES UpdateOctober 29, 2020
NPPES CertifiedOctober 29, 2020
✔ NPI 1336167576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NC · C001902
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.
175 KIMEL PARK DR STE 100, Winston Salem, NC 27103
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Other Names 1

Other Name (5)M Michele Johnson Lcsw

Other Identifiers 1

Medicaid6106234NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Millicent Johnson Shadden Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.12 – $165.09
Typical copayment $0.00 (range $13.53 – $41.27)
Most-billed visit code NA
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MINDY PARIS FRANCE NCC, LPC
Counselor (Professional)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 277-1800
ERIN TAGGE
Counselor (Mental Health)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
TRESSA ANITA CORBETT LCSW, LCAS
Social Worker (Clinical)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
MRS. MIKALA JONES DILLARD PMHNP-BC
Nurse Practitioner
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
KATHRYN MICHELLE MURRAY LCSW
Social Worker (Clinical)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
ALISON BRIDGES RUSSO LCSW
Social Worker (Clinical)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
COREY LANE GOSNELL PA-C
Physician Assistant
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
BRIAN ANDREW FARAH M.D.
Psychiatry & Neurology (Psychiatry)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550

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 Millicent Shadden's NPI number?

The NPI number for Millicent Shadden is 1336167576. It was assigned to this individual provider in the NPPES registry on July 17, 2006. The provider is also known as M Michele Johnson Lcsw.

Where is Millicent Shadden located?

Millicent Shadden practices at 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103. The listed phone number is (336) 718-3550.

What is Millicent Shadden's specialty?

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

Is Millicent Shadden enrolled in Medicare?

Yes. Millicent Shadden is registered in the Medicare PECOS enrollment system.

What insurance does Millicent Shadden accept?

Health plans from Blue Cross and Blue Shield of NC and Oscar Health Plan of North Carolina, Inc list Millicent Shadden 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 Millicent Shadden was last updated on October 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.