NPIMap

Organization Active NPI

Phoenix Counseling of Gaston Lincoln

  • Community/Behavioral Health Agency
  • Shelby, NC
National Provider Identifier
1093974537
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PHOENIX COUNSELING OF GASTON LINCOLN
Practice address
917 1St St
Shelby, NC 28150-3958
Phone
(704) 921-3070
Fax
(704) 921-3066
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Mr. Kevin P Oliver, MA MPA
Title
Executive Director
Phone
(704) 921-3070

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X NC
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X NC
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

917 1St St
Shelby, NC 28150-3958

Mailing address

4007 Wild Nursery CT
Charlotte, NC 28215-5345
Phone (704) 921-3070

Other names 1

  • Phoenix Counseling Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Counseling Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1093974537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 WILD NURSERY CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282155345",
            "telephone_number": "704-921-3070",
            "fax_number": "704-921-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 1ST ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503958",
            "telephone_number": "704-921-3070",
            "fax_number": "704-921-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX COUNSELING OF GASTON LINCOLN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-921-3070",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA MPA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.