Therapeutic Intervention Group, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

THERAPEUTIC INTERVENTION GROUP, LLC

Practice address

1100 S Mint St
Suite 108
Charlotte, NC 28203-4049

Phone

(704) 927-9695

NPI assigned

Jul 20, 2011

Organization subpart

No

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

Authorized official

Name

Carlton Gunning

Title

Owner

Phone

(704) 927-9695

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1275821597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S MINT ST",
            "address_2": "SUITE 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034049",
            "telephone_number": "704-927-9695",
            "fax_number": "704-927-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S MINT ST",
            "address_2": "SUITE 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034049",
            "telephone_number": "704-927-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC INTERVENTION GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "GUNNING",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-927-9695"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.