Organization Active NPI

Endeavor Counseling Group PLLC

  • Community/Behavioral Health Agency
  • Waxhaw, NC
National Provider Identifier
1588065718
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
529 Issued in NC
Legal business name
ENDEAVOR COUNSELING GROUP PLLC
Practice address
400 N Broome St
Waxhaw, NC 28173-7032
Phone
(516) 551-4942
NPI assigned
Sep 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Authorized official

Name
Cristen MontagninoNPI 1730474248
Title
Manager
Phone
(516) 551-4942

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 529 NC Primary

Addresses

Primary practice location

400 N Broome St
Waxhaw, NC 28173-7032

Mailing address

2104 Coral Berry LN
Waxhaw, NC 28173-8089
Phone (516) 551-4942

National Provider Directory

National Provider Directory

Locations

400 N Broome St
Ste 302
Waxhaw, NC 28173

400 N Broome St
Waxhaw, NC 28173
Phone (516) 551-4942

Practitioners & affiliated clinicians

Practitioners 1

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": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1588065718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 CORAL BERRY LN",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281738089",
            "telephone_number": "516-551-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BROOME ST",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737032",
            "telephone_number": "516-551-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOR COUNSELING GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "MONTAGNINO",
        "authorized_official_first_name": "CRISTEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-551-4942"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.