336-625-1679
336-625-4246
Email Us

Update Contact Information Form

Pursuant to NC Administrative Code [21 NCAC 63 .0405], Social Workers certified or licensed by the Board are required to notify the Board in writing of changes to contact information within 30 days of the effective date of any such change. [IMPORTANT NOTE: Changes to name require submission of a legal document reflecting the new/changed name. Please submit the NAME/ADDRESS CHANGE form – located under the Certification & Licensure / Forms tab – along with a copy of the legal document to the Board via mail (NCSWCLB, P.O. Box 1043, Asheboro, NC 27204) or fax (1-336-625-4246)].

Name*
First Last
License Number*
Address*
Street Address Address Line 2 City State ZIP Code
Email
Current Business Name and Address
LCSW licensees currently listed on the LCSW Supervisor Roster posted on the Board's website (as a courtesy), must also inform the Board if a change needs to be made to list information and/or if they wish to be removed from that list.
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Mailing Address

P.O. Box 1043
Asheboro, NC 27204

Physical Address

1207 S. Cox Street, Suite F
Asheboro, NC 27203

Phone Numbers

Office: 336-625-1679
Fax: 336-625-4246
EMAIL US

This website is considered a primary source for North Carolina Social Work Certification and Licensure Board (NCSWCLB) data. Credentialing information is current (updated in real time) and is the same information the Board provides through other means, such as telephone, fax, mail, or email.

All information provided by the NCSWCLB on this web site is made available as a service to the public. While every attempt is made to ensure that the information contained herein is both accurate and current, the Board makes no guarantee or warranty, either expressed or implied, concerning the accuracy or reliability of the content of this website or the content of any other website to which it may link. It is the responsibility of the user to assess the accuracy and reliability of the information obtained from this website; and the Board assumes no responsibility for, nor shall the Board be liable for errors contained herein or for any damages resulting from the use of information obtained from this website.

If you believe that information obtained from this site is inaccurate or out-of-date, or you encounter technical problems when using or accessing this site, please notify the Board’s Administrative Office

Contact Information:

Physical Address:

1207 S. Cox Street, Suite F
Asheboro, NC 27203

Phone: 336-625-1679 Fax: 336-625-4246

Update Contact Information Form

Updating Contact Information and Name Changes

Mailing Address

Physical Address

Phone Numbers

Contact Information:

Physical Address:

NCSWCLB Mailing Address:

Business Hours:

Monday – Friday: 9AM - 5PM