Organization Active NPI

Open Gate Counseling Services PLLC

  • Professional Counselor
  • Shallotte, NC
National Provider Identifier
1609336981
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
OPEN GATE COUNSELING SERVICES PLLC
Practice address
143 Holden Beach Rd SW Ste 3
Shallotte, NC 28470-1918
Phone
(910) 755-5182
Fax
(910) 312-3155
NPI assigned
Mar 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Authorized official

Name
Mrs. Brittany Oxendine Jozefowicz, LCMHCNPI 1598207953
Title
Owner/Therapist
Phone
(910) 228-0913

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 SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

143 Holden Beach Rd SW Ste 3
Shallotte, NC 28470-1918

Mailing address

PO Box 2485
Shallotte, NC 28459-2485
Phone (910) 755-5182

Other identifiers 1

IdentifierTypeStateIssuer
28618MedicaidNC

National Provider Directory

National Provider Directory

Locations

117 Holden Beach Rd SW
Ste 109A
Shallotte, NC 28470

143 Holden Beach Rd SW
Ste 3
Shallotte, NC 28470
Phone (910) 755-5182

Practitioners & affiliated clinicians

Practitioners 2

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": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1609336981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2485",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284592485",
            "telephone_number": "910-755-5182",
            "fax_number": "910-312-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 HOLDEN BEACH RD SW STE 3",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284701918",
            "telephone_number": "910-755-5182",
            "fax_number": "910-312-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN GATE COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "JOZEFOWICZ",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "OXENDINE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "910-228-0913",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28618",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.