NPIMap

Organization Active NPI

Leadership and Resilience Consultants, PC

  • Marriage & Family Therapist
  • Fort Mill, SC
National Provider Identifier
1508842923
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT000954G Issued in GA
Legal business name
LEADERSHIP AND RESILIENCE CONSULTANTS, PC
Practice address
200 Forest Ridge Dr
Fort Mill, SC 29715-6418
Phone
(803) 543-7617
Fax
(800) 858-2194
NPI assigned
Dec 17, 2005
Last updated
Dec 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Mrs. Kimberly Lannette Wilson, LMFTNPI 1265587430
Title
Chief Executive Officer
Phone
(704) 769-0660

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
Marriage & Family Therapist 106H00000X MFT000954G GA Primary

Addresses

Primary practice location

200 Forest Ridge Dr
Fort Mill, SC 29715-6418

Mailing address

15105D John J Delaney Dr Ste 192
Charlotte, NC 28277-2741
Phone (704) 769-0660

Other practice location 1

15105D John J Delaney Dr Ste 192
Charlotte, NC 28277-2741
Phone (704) 769-0660

National Provider Directory

National Provider Directory

Locations

15105D John J Delaney Dr
Charlotte, NC 28277
Phone (704) 769-0660

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": "1134777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1508842923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15105D JOHN J DELANEY DR STE 192",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282772741",
            "telephone_number": "704-769-0660",
            "fax_number": "800-858-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FOREST RIDGE DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156418",
            "telephone_number": "803-543-7617",
            "fax_number": "800-858-2194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15105D John J Delaney Dr Ste 192",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282772741",
            "country_code": "US",
            "telephone_number": "704-769-0660",
            "fax_number": "800-858-2194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEADERSHIP AND RESILIENCE CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-17",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "LANNETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "704-769-0660",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT000954G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.