NPIMap

Organization Active NPI

Groundwater Solutions, Inc.

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1013532456
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GROUNDWATER SOLUTIONS, INC.
Practice address
5104 Reagan Dr Ste 5
Charlotte, NC 28206-1392
Phone
(704) 596-0505
Fax
(704) 596-0507
NPI assigned
Jun 11, 2020
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Trasha Black, PHD LCMHCNPI 1730119363
Title
President
Phone
(704) 596-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Lodging Provider 177F00000X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Voluntary or Charitable Agency 251V00000X
Community Health Clinic/Center 261QC1500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Primary Care Clinic/Center 261QP2300X
Recovery Care Clinic/Center 261QR0800X
Religious Nonmedical Health Care Institution 282J00000X
Transportation Broker 347E00000X

Addresses

Primary practice location

5104 Reagan Dr Ste 5
Charlotte, NC 28206-1392

Mailing address

5104 Reagan Dr Ste 5
Charlotte, NC 28206-1392
Phone (704) 596-0505

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Charlotte Genesis Project 1, Inc

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1013532456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 REAGAN DR STE 5",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282061392",
            "telephone_number": "704-596-0505",
            "fax_number": "704-596-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5104 REAGAN DR STE 5",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282061392",
            "telephone_number": "704-596-0505",
            "fax_number": "704-596-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUNDWATER SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "TRASHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-596-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Charlotte",
            "affiliation": "Y",
            "affiliationName": "Genesis Project 1, Inc",
            "address_1": "5104 Reagan Dr Ste 5",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282061392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.