Southside Counseling Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

8778 Issued in NC

Legal business name

SOUTHSIDE COUNSELING CENTER, LLC

Practice address

2015 Ayrsley Town Blvd Ste 202
Charlotte, NC 28273-4068

Phone

(704) 280-8531

NPI assigned

Jun 17, 2012

Organization subpart

No

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

Authorized official

Name

Erin E Rice, LPC

Title

Owner/Member

Phone

(828) 545-0601

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339891200000",
    "number": "1356604235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 AYRSLEY TOWN BLVD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734068",
            "telephone_number": "704-280-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 AYRSLEY TOWN BLVD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734068",
            "telephone_number": "704-280-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-17",
        "last_updated": "2012-06-17",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "828-545-0601",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "8778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104978",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2012; 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.