Organization Active NPI

Porcelain Dolls of the Carolinas, Inc

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1417435710
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PORCELAIN DOLLS OF THE CAROLINAS, INC
Practice address
5835 Executive Center Dr # 101-I
Charlotte, NC 28212
Phone
(704) 606-7824
NPI assigned
Jul 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Lisa M LeeNPI 1437814233
Title
Executive Director
Phone
(704) 951-5987

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Community/Behavioral Health Agency 251S00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Point of Service 305S00000X

Addresses

Primary practice location

5835 Executive Center Dr # 101-I
Charlotte, NC 28212

Mailing address

13000 S Tryon St # F-122
Charlotte, NC 28278-7652
Phone (704) 951-5987

Other names 1

  • Porcelain Dolls Other name

National Provider Directory

National Provider Directory

Locations

5835 Executive Center Dr
#101I
Charlotte, NC 28212
Phone (704) 606-7824

13000 S Tryon St
#F122
Charlotte, NC 28278

Practitioners & affiliated clinicians

Practitioners 1

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": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1417435710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 S TRYON ST # F-122",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787652",
            "telephone_number": "704-951-5987",
            "fax_number": "980-219-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5835 EXECUTIVE CENTER DR # 101-I",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28212",
            "telephone_number": "704-606-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORCELAIN DOLLS OF THE CAROLINAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-951-5987"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porcelain Dolls",
            "code": "5",
            "type": "Other 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 Nov 5, 2021; 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.