Excel Outreach and Supportive Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

EXCEL OUTREACH AND SUPPORTIVE SERVICES LLC

Practice address

1503 Denim Dr Ste 101
Erwin, NC 28339-3017

Phone

(910) 409-8476

NPI assigned

Aug 25, 2011

Organization subpart

No

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

Authorized official

Name

Sharita Lawson

Title

Ceo

Phone

(910) 409-8476

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1528348265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 DENIM DR STE 101",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283393017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 DENIM DR STE 101",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283393017",
            "telephone_number": "910-409-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL OUTREACH AND SUPPORTIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "SHARITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-409-8476"
    },
    "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sonya Godwin
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• Mental Health Counselor in Erwin, NC
• Providers in Erwin, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.