NPIMap

Organization Active NPI

Charlotte Counseling and Wellness Center, PLLC

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1598083230
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7193 Issued in NC
Legal business name
CHARLOTTE COUNSELING AND WELLNESS CENTER, PLLC
Practice address
1811 Sardis Rd N Ste 207
Charlotte, NC 28270-3000
Phone
(757) 285-0565
Fax
(704) 256-4893
NPI assigned
May 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Authorized official

Name
Diana A Moser-Burg, MHS, LPCNPI 1629229349
Title
Sole Proprietor
Phone
(704) 256-4893

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
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 7193 NC Primary

Addresses

Primary practice location

1811 Sardis Rd N Ste 207
Charlotte, NC 28270-3000

Mailing address

1211 Applegate Pkwy
Waxhaw, NC 28173-6726
Phone (704) 256-4893

Other identifiers 1

IdentifierTypeStateIssuer
6104058MedicaidNC

National Provider Directory

National Provider Directory

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": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1598083230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 APPLEGATE PKWY",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736726",
            "telephone_number": "704-256-4893",
            "fax_number": "704-256-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 SARDIS RD N STE 207",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282703000",
            "telephone_number": "757-285-0565",
            "fax_number": "704-256-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE COUNSELING AND WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "MOSER-BURG",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "704-256-4893",
        "authorized_official_credential": "MHS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104058",
            "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 May 5, 2010; 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.