Integrative Therapeutic Counseling Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INTEGRATIVE THERAPEUTIC COUNSELING SERVICES

Doing business as

Integrative Therapeutic Counseling Services

Practice address

1101 Tyvola Rd Ste 218
Charlotte, NC 28217-3515

Phone

(540) 320-2859

NPI assigned

Nov 13, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Sheena Ilean Hasty, LCASA-23287

Title

Ceo

Phone

(540) 320-2859

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Integrative Therapeutic Counseling Services Doing business as

Locations

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1366911919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 PINE TREE ES DR",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281440517",
            "telephone_number": "540-320-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 TYVOLA RD STE 218",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173515",
            "telephone_number": "540-320-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE THERAPEUTIC COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "HASTY",
        "authorized_official_first_name": "SHEENA",
        "authorized_official_middle_name": "ILEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "540-320-2859",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCASA-23287"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992985972",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrative Therapeutic Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.