Organization Active NPI

Clear Vista Counseling PLLC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1396368767
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CLEAR VISTA COUNSELING PLLC
Practice address
1218 East Blvd Ste E
Charlotte, NC 28203-6158
Phone
(704) 912-1074
NPI assigned
May 20, 2020
Last updated
May 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Authorized official

Name
Theresa Leskowat, MS LCMHC
Title
Owner
Phone
(918) 207-6499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1218 East Blvd Ste E
Charlotte, NC 28203-6158

Mailing address

3838 Saxonbury Way
Charlotte, NC 28269-9437

Other identifiers 1

IdentifierTypeStateIssuer
1659675304MedicaidOK

National Provider Directory

National Provider Directory

Locations

1218 East Blvd
Ste E
Charlotte, NC 28203
Phone (704) 912-1074

Practitioners & affiliated clinicians

Practitioners 3

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": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1396368767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 SAXONBURY WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282699437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 EAST BLVD STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036158",
            "telephone_number": "704-912-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR VISTA COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "LESKOWAT",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-207-6499",
        "authorized_official_credential": "MS LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659675304",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 20, 2020; 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.