Active NPI
Elliot Sanchez, PHD, LCMHC, LCASA
- Mental Health Counselor
- Gastonia, NC
National Provider Identifier
1205261443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12968
- Practice address
- 409 S Oakland St
Gastonia, NC 28052-4312 - Phone
- (704) 874-9005
- Fax
- (704) 874-9001
- NPI assigned
- Sep 6, 2013
- Last updated
- Sep 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | 12968 | NC | Primary |
| Pastoral Counselor | 101YP1600X | |||
| Professional Counselor | 101YP2500X |
Addresses
Primary practice location
409 S Oakland St
Gastonia, NC 28052-4312
Mailing address
200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1900
Other practice location 1
119 Millen Dr
Mooresville, NC 28115-5814
Phone (704) 574-2743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12968 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rise Counseling PLLC | Current | Accepting new patients |
Interoperability endpoints
- esanchez320586@direct.ochin.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Mooresville, NC
- NPI 1609508563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1205261443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E 2ND AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524358",
"telephone_number": "704-874-1900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 S OAKLAND ST",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524312",
"telephone_number": "704-874-9005",
"fax_number": "704-874-9001"
}
],
"practiceLocations": [
{
"address_1": "119 Millen Dr",
"address_purpose": "LOCATION",
"city": "Mooresville",
"state": "NC",
"postal_code": "281155814",
"country_code": "US",
"telephone_number": "704-574-2743",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANCHEZ",
"first_name": "ELLIOT",
"name_prefix": "Mr.",
"credential": "PHD, LCMHC, LCASA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-06",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "12968",
"primary": true
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"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 Sep 23, 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.