Celebrity Therapeutic Services,PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8967 Issued in NC

Legal business name

CELEBRITY THERAPEUTIC SERVICES,PLLC

Practice address

4819 Emperor Blvd
Suite 400
Durham, NC 27703-5420

Phone

(301) 455-3415

NPI assigned

Jun 10, 2015

Organization subpart

No

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

Authorized official

Name

Dana Robinson, LPC, NCC, LCAS-A,

Title

Owner/Organizer

Phone

(301) 455-3415

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1487035911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 EMPEROR BLVD",
            "address_2": "SUITE 400",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277035420",
            "telephone_number": "301-455-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4819 EMPEROR BLVD",
            "address_2": "SUITE 400",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277035420",
            "telephone_number": "301-455-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELEBRITY THERAPEUTIC SERVICES,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "OWNER/ORGANIZER",
        "authorized_official_telephone_number": "301-455-3415",
        "authorized_official_credential": "LPC, NCC, LCAS-A,"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NC",
            "license": "333976",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "21143",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.