NPIMap

Organization Active NPI

Sanctuary Counseling Group

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1386785251
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0000 Issued in NC
Legal business name
SANCTUARY COUNSELING GROUP
Practice address
2129 E 7TH St
Charlotte, NC 28204-3337
Phone
(704) 375-5354
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Willard J CobbNPI 1396290359
Title
Executive Director
Phone
(704) 617-3910

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 0000 NC Primary

Addresses

Primary practice location

2129 E 7TH St
Charlotte, NC 28204-3337

Mailing address

2129 E 7TH St
Charlotte, NC 28204-3337
Phone (704) 375-5354

Other names 1

  • Methodist Counseling and Consultation Services Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcobb@scgnc.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260410001067 NC Part B Supplier - Clinic/Group Practice 8527533140 Receives reassigned benefits from 11 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

461 Howard St
Boone, NC 28607

325 N Broad St
Brevard, NC 28712

2129 E 7th St
Charlotte, NC 28204

1801 E 5th St
Ste 110
Charlotte, NC 28204

4200 McKee Rd
Charlotte, NC 28270

3835 W W T Harris Blvd
Charlotte, NC 28269

19600 Zion Ave
Cornelius, NC 28031

1701 E Market St
Greensboro, NC 27401

1245 6th Ave W
Hendersonvlle, NC 28739

801 S Hayne St
Monroe, NC 28112

15008 Lancaster Hwy
Pineville, NC 28134

217 S Church St
Salisbury, NC 28144

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1386785251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043337",
            "telephone_number": "704-375-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043337",
            "telephone_number": "704-375-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY COUNSELING GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "WILLARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-617-3910"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "0000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcobb@scgnc.org",
            "affiliation": "N",
            "endpointDescription": "Officer email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2129 E 7th St",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Methodist Counseling and Consultation Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.