NPIMap

Organization Active NPI

Perry Counseling Healing and Recovery PLLC

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1508488917
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PERRY COUNSELING HEALING AND RECOVERY PLLC
Practice address
811 Central Ave Ste 8
Charlotte, NC 28204-2015
Phone
(704) 908-4061
NPI assigned
May 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2020

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

Authorized official

Name
Mr. Justin Lloyd Perry, LCSW, LCASNPI 1316175201
Title
Owner
Phone
(704) 908-4061

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

811 Central Ave Ste 8
Charlotte, NC 28204-2015

Mailing address

2009 Stratford Ave
Charlotte, NC 28205-2454

Other practice location 1

5200 Park Rd
Charlotte, NC 28209-3650
Phone (704) 908-4061

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://secure.simplepractice.com/ Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

811 Central Ave
Ste 8
Charlotte, NC 28204
Phone (704) 340-8858

5200 Park Rd
Charlotte, NC 28209
Phone (704) 629-8067

Practitioners & affiliated clinicians

Practitioners 1

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": "1588896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588896000000",
    "number": "1508488917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 STRATFORD AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CENTRAL AVE STE 8",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042015",
            "telephone_number": "704-908-4061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282093650",
            "country_code": "US",
            "telephone_number": "704-908-4061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERRY COUNSELING HEALING AND RECOVERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-08",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-908-4061",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://secure.simplepractice.com/",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "811 Central Ave Ste 8",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 8, 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.