NPIMap

Organization Active NPI

Children's Advocacy Network, LLC

  • Mental Health Counselor
  • Gastonia, NC
National Provider Identifier
1023316361
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CHILDREN'S ADVOCACY NETWORK, LLC
Practice address
1371 E Garrison Blvd Ste a
Gastonia, NC 28054
Phone
(704) 833-0154
Fax
(704) 833-7076
NPI assigned
Mar 10, 2011
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mrs. Kimberly O Beaudoin, MA
Title
Co-Owner
Phone
(704) 833-0154

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

1371 E Garrison Blvd Ste a
Gastonia, NC 28054

Mailing address

1371 E Garrison Blvd Ste a
Gastonia, NC 28054-5155
Phone (704) 833-0154

National Provider Directory

National Provider Directory
Tax ID family
Children's Advocacy Network LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1371 E Garrison Blvd
Ste A
Gastonia, NC 28054
Phone (704) 833-0154

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1023316361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 E GARRISON BLVD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545155",
            "telephone_number": "704-833-0154",
            "fax_number": "704-833-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 E GARRISON BLVD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-833-0154",
            "fax_number": "704-833-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S ADVOCACY NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-10",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "BEAUDOIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "704-833-0154",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.