NPIMap

Organization Active NPI

Modern Era Counseling, PLLC

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1518508340
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MODERN ERA COUNSELING, PLLC
Practice address
4730 Park Rd Ste a
Charlotte, NC 28209-4205
Phone
(704) 317-7638
NPI assigned
Oct 2, 2019
Last updated
Oct 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Matthew R Smith, LCMHCNPI 1114446002
Title
Owner & Therapist
Phone
(704) 954-8295

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
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

4730 Park Rd Ste a
Charlotte, NC 28209-4205

Mailing address

4730 Park Rd Ste a
Charlotte, NC 28209-4205
Phone (704) 317-7638

Other practice location 1

1300 Baxter St Ste 460
Charlotte, NC 28204-3080
Phone (704) 317-7638

National Provider Directory

National Provider Directory

Locations

1300 Baxter St
Ste 460
Charlotte, NC 28204
Phone (704) 317-7638

4730 Park Rd
Ste A
Charlotte, NC 28209
Phone (704) 317-7638

5200 Park Rd
Ste 218D
Charlotte, NC 28209

Practitioners & affiliated clinicians

Practitioners 9

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": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1518508340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 PARK RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094205",
            "telephone_number": "704-317-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 PARK RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094205",
            "telephone_number": "704-317-7638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Baxter St Ste 460",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043080",
            "country_code": "US",
            "telephone_number": "704-317-7638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN ERA COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER & THERAPIST",
        "authorized_official_telephone_number": "704-954-8295",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 2, 2023; 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.