NPIMap

Organization Active NPI

2ND II None Foundation

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1114001088
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6005700 Issued in NC
Legal business name
2ND II NONE FOUNDATION
Practice address
5820 E WT Harris Blvd
Suite 111
Charlotte, NC 28215-3541
Phone
(704) 566-6134
Fax
(704) 566-6136
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Thomas Scott Corbett, MA, LMHC, LPC, NCC
Title
Clinical Director
Phone
(704) 566-6134

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 6005700 NC Primary

Addresses

Primary practice location

5820 E WT Harris Blvd
Suite 111
Charlotte, NC 28215-3541

Mailing address

PO Box 480794
Charlotte, NC 28269-5323
Phone (704) 566-6134

Other identifiers 1

IdentifierTypeStateIssuer
6005700MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
2ND II None Foundation8 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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114001088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480794",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282695323",
            "telephone_number": "704-566-6134",
            "fax_number": "704-566-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 E WT HARRIS BLVD",
            "address_2": "SUITE 111",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153541",
            "telephone_number": "704-566-6134",
            "fax_number": "704-566-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2ND II NONE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "704-566-6134",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LMHC, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "6005700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005700",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "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 Aug 22, 2020; 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.