Crown King Therapy LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CROWN KING THERAPY LLC

Practice address

11915 N Tryon St Ste F
Charlotte, NC 28262-4995

Phone

(704) 606-4245

Fax

(704) 606-4245

NPI assigned

Sep 17, 2025

Last updated

Sep 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reuben G Jackson

Title

Owner

Phone

(704) 606-4245

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1235000589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11915 N TRYON ST STE F",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624995",
            "telephone_number": "704-606-4245",
            "fax_number": "704-606-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11915 N TRYON ST STE F",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624995",
            "telephone_number": "704-606-4245",
            "fax_number": "704-606-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN KING THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-606-4245"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.