South Charlotte Behavioral Health

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

163529 Issued in NC

Legal business name

SOUTH CHARLOTTE BEHAVIORAL HEALTH

Practice address

9635 Southern Pine Blvd Ste 126
9635 Southern Pine Blvd Suite 126 Charlotte Nc28273
Charlotte, NC 28273-5558

Phone

(704) 749-3808

Fax

(704) 749-3809

NPI assigned

Jul 18, 2011

Organization subpart

No

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

Authorized official

Name

Dr. James Earl Lee Jr., M.D.,

Title

Owner

Phone

(704) 749-3808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1578851093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9635 SOUTHERN PINE BLVD STE 126",
            "address_2": "9635 SOUTHERN PINE BLVD SUITE 126 CHARLOTTE NC28273",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282735558",
            "telephone_number": "704-749-3808",
            "fax_number": "704-749-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 SOUTHERN PINE BLVD STE 126",
            "address_2": "9635 SOUTHERN PINE BLVD SUITE 126 CHARLOTTE NC28273",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282735558",
            "telephone_number": "704-749-3808",
            "fax_number": "704-749-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CHARLOTTE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-749-3808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "163529",
            "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 Jul 18, 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.