Individual provider Active NPI

Tia Renee Anderson-Crowder, LPC-A

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1306309752
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A14745 Issued in NC
Practice address
5700 Executive Center Dr Ste 110
Charlotte, NC 28212-8833
Phone
(704) 525-3255
NPI assigned
Apr 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A14745 NC Primary

Addresses

Primary practice location

5700 Executive Center Dr Ste 110
Charlotte, NC 28212-8833

Mailing address

6926 Rumple Rd
Charlotte, NC 28262-3141
Phone (704) 578-0785

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A14745NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1306309752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6926 RUMPLE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623141",
            "telephone_number": "704-578-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 EXECUTIVE CENTER DR STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128833",
            "telephone_number": "704-525-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-CROWDER",
        "first_name": "TIA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A14745",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 12, 2019; 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.