Organization Active NPI

Carolina Community Counseling LLC

  • Professional Counselor
  • Fort Mill, SC
National Provider Identifier
1063993525
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6113 Issued in SC
Legal business name
CAROLINA COMMUNITY COUNSELING LLC
Practice address
2012 Highway 160 W Ste 9
Fort Mill, SC 29708-8401
Phone
(866) 652-0093
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Authorized official

Name
Kirsten Davis, MA, LPCNPI 1306180575
Title
Therapist
Phone
(866) 652-0093

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6113 SC Primary

Addresses

Primary practice location

2012 Highway 160 W Ste 9
Fort Mill, SC 29708-8401

Mailing address

2012 Highway 160 W Ste 9
Fort Mill, SC 29708-8401
Phone (866) 652-0093

National Provider Directory

National Provider Directory

Locations

2012 Highway 160 W
Ste 9
Fort Mill, SC 29708
Phone (866) 652-0093

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": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534982400000",
    "number": "1063993525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 HIGHWAY 160 W STE 9",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088401",
            "telephone_number": "866-652-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 HIGHWAY 160 W STE 9",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088401",
            "telephone_number": "866-652-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA COMMUNITY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "866-652-0093",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.