Individual provider Active NPI

Janet Serita Oliver, LPC

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1073707402
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6611 Issued in NC
Practice address
5130 Queen Anne Rd
Charlotte, NC 28217-2037
Phone
(704) 576-5408
Fax
(704) 523-5608
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6611 NC Primary

Addresses

Primary practice location

5130 Queen Anne Rd
Charlotte, NC 28217-2037

Mailing address

5130 Queen Anne Rd
Charlotte, NC 28217-2037
Phone (704) 576-5408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325002766 NC Practitioner - Mental Health Counselor 2163869231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soul Care, PLLCGroup PAC ID 8224329008, 5 clinicians

Practice addresses (Care Compare)

5501 Executive Ctr Dr
Suite 215
Charlotte, NC 28212-8823
Phone (980) 613-8312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6611NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver'S Contracting, Consulting, & Counseling Services, PLLC Professional CurrentSince May 3, 2020 Accepting new patients
Soul Care, PLLC Professional CurrentSince Feb 10, 2024 Accepting new patients

Locations

4108 Park Rd
Ste 408
Charlotte, NC 28209
Phone (980) 907-2466

5501 Executive Center Dr
Ste 215
Charlotte, NC 28212
Phone (704) 237-0881

3695 Sunset Ave
Unit 8936
Rocky Mount, NC 27804

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1073707402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 QUEEN ANNE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172037",
            "telephone_number": "704-576-5408",
            "fax_number": "704-523-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 QUEEN ANNE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172037",
            "telephone_number": "704-576-5408",
            "fax_number": "704-523-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "JANET",
        "middle_name": "SERITA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "6611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.