Latoya Jewelldine Conner, LCSWA is a medicare enrolled "Social Worker - Clinical" provider in Charlotte, North Carolina. Her current practice location is
3623 Latrobe Dr Ste 119, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(980) 502-9615.
Latoya Jewelldine Conner is licensed to practice in North Carolina (license number P015123) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1619641867.
Healthcare Provider's Profile
| Full Name | Latoya Jewelldine Conner |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 3623 Latrobe Dr Ste 119, Charlotte, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1619641867
- Provider Enumeration Date: 08/02/2021
- Last Update Date: 08/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 5698203982
- Enrollment ID: I20250128004520
Medical Identifiers
Medical identifiers for Latoya Jewelldine Conner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619641867 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LCAS-30286 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | P015123 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Latoya Jewelldine Conner allows following entities to bill medicare on her behalf.
| Entity Name | A Jewel's Journey Therapeutic & Consulting Services Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861220279
PECOS PAC ID: 4789112079
Enrollment ID: O20250114003814 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Latoya Jewelldine Conner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Latoya Jewelldine Conner, LCSWA
8533 Wren Creek Dr,
Charlotte, NC 28269-6179
Ph: (980) 349-5777 | Latoya Jewelldine Conner, LCSWA
3623 Latrobe Dr Ste 119,
Charlotte, NC 28211-1187
Ph: (980) 502-9615 |
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