NPIMap

Organization Active NPI

Child & Family Therapy Center PC

  • Professional Counselor
  • Conover, NC
National Provider Identifier
1396074159
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
851 Issued in NC
Legal business name
CHILD & FAMILY THERAPY CENTER PC
Practice address
715 Fairgrove Church Rd SE
Suite 102
Conover, NC 28613-9290
Phone
(704) 664-7148
Fax
(704) 664-3086
NPI assigned
Dec 8, 2009
Last updated
Mar 3, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILD & FAMILY THERAPY CENTER PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Authorized official

Name
Mrs. Pamela H James
Title
Office Manager
Phone
(704) 664-7148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 851 NC Primary

Addresses

Primary practice location

715 Fairgrove Church Rd SE
Suite 102
Conover, NC 28613-9290

Mailing address

363 Williamson Rd
Suite 102
Mooresville, NC 28117-5974
Phone (704) 664-7148

Other identifiers 1

IdentifierTypeStateIssuer
6006780MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Child Family Therapy Center PC2 organizations share this tax ID, including this one
Part of
Child Family Therapy Center PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

715 Fairgrove Church Rd SE
Ste 102
Conover, NC 28613
Phone (704) 664-7148

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1396074159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 WILLIAMSON RD",
            "address_2": "SUITE 102",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175974",
            "telephone_number": "704-664-7148",
            "fax_number": "704-664-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 FAIRGROVE CHURCH RD SE",
            "address_2": "SUITE 102",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286139290",
            "telephone_number": "704-664-7148",
            "fax_number": "704-664-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & FAMILY THERAPY CENTER PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILD & FAMILY THERAPY CENTER PC",
        "enumeration_date": "2009-12-08",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-664-7148",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006780",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conover, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.