NPIMap

Organization Active NPI

Southerland Treatment and Rehab(Star) Counseling&Consulting SVCS, PLLC

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1396215737
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SOUTHERLAND TREATMENT AND REHAB(STAR) COUNSELING&CONSULTING SVCS, PLLC
Practice address
206 Fair Oaks LN
Winston Salem, NC 27127-3178
Phone
(336) 745-7179
Fax
(336) 842-3055
NPI assigned
Nov 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Authorized official

Name
Timeka A Southerland, LPCS, CSOTS, TFCBTNPI 1215163167
Title
Owner/LPCS
Phone
(336) 745-7179

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
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

206 Fair Oaks LN
Winston Salem, NC 27127-3178

Mailing address

206 Fair Oaks LN
Winston Salem, NC 27127-3178
Phone (336) 745-7179

Other names 1

  • S.T.A.R. Counseling & Consulting Services, PLLC Other name

National Provider Directory

National Provider Directory

Locations

206 Fair Oaks Ln
Winston Salem, NC 27127
Phone (336) 745-7179

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1396215737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 FAIR OAKS LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273178",
            "telephone_number": "336-745-7179",
            "fax_number": "336-842-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 FAIR OAKS LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273178",
            "telephone_number": "336-745-7179",
            "fax_number": "336-842-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERLAND TREATMENT AND REHAB(STAR) COUNSELING&CONSULTING SVCS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "TIMEKA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/LPCS",
        "authorized_official_telephone_number": "336-745-7179",
        "authorized_official_credential": "LPCS, CSOTS, TFCBT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S.T.A.R. Counseling & Consulting Services, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.