Organization Active NPI

Kingsley Road Counseling and Consulting Group, PLLC

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1477214641
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
KINGSLEY ROAD COUNSELING AND CONSULTING GROUP, PLLC
Practice address
6747 Fairview Rd Ste C
Charlotte, NC 28210-3359
Phone
(980) 285-3952
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Mrs. Ann Clay ChurchNPI 1720588783
Title
Owner
Phone
(980) 285-3952

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

6747 Fairview Rd Ste C
Charlotte, NC 28210-3359

Mailing address

3431 Selwyn Farms LN
Charlotte, NC 28209-4030
Phone (980) 285-3952

National Provider Directory

National Provider Directory

Locations

6747 Fairview Rd
Ste C
Charlotte, NC 28210
Phone (704) 981-1898

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": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1477214641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 SELWYN FARMS LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094030",
            "telephone_number": "980-285-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6747 FAIRVIEW RD STE C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103359",
            "telephone_number": "980-285-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSLEY ROAD COUNSELING AND CONSULTING GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-285-3952",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 10, 2022; 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.