NPIMap

Organization Active NPI

Fullscope Counseling Services

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1588030738
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S7583 Issued in NC
Legal business name
FULLSCOPE COUNSELING SERVICES
Practice address
10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001
Phone
(704) 493-5856
Fax
(704) 703-8661
NPI assigned
Aug 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Catherine L Ladson
Title
Therapist/Owner
Phone
(612) 388-6614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X S7583 NC Primary

Addresses

Primary practice location

10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001

Mailing address

10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001
Phone (704) 493-5856

Other identifiers 1

IdentifierTypeStateIssuer
6104325MedicaidNC

National Provider Directory

National Provider Directory

Locations

1554 Union Rd
Ste 2
Gastonia, NC 28054

Practitioners & affiliated clinicians

Practitioners 5

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": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1588030738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 MALLARD CREEK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282626001",
            "telephone_number": "704-493-5856",
            "fax_number": "704-703-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 MALLARD CREEK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282626001",
            "telephone_number": "704-493-5856",
            "fax_number": "704-703-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLSCOPE COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2022-09-19",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "LADSON",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "612-388-6614"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S7583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104325",
            "state": "NC"
        }
    ],
    "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 Sep 19, 2022; 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.