Inner Transformation Therapeutic Services, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INNER TRANSFORMATION THERAPEUTIC SERVICES, PLLC

Practice address

10130 Perimeter Parkway Suite 200 - #0425
Charlotte, NC 28216

Phone

(980) 230-8880

Fax

(844) 841-1302

NPI assigned

Jul 12, 2014

Organization subpart

No

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

Authorized official

Name

Correlia D Johnson, LCSW, LISW-CP, LCAS

Title

Owner

Phone

(980) 230-8880

Specialties & licenses 2

Addresses

Other names 1

• INNER TRANSFORMATION THERAPEUTIC SERVICES, PLLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Correlia D Campbell, LCSW, LCAS, LISW-CP

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1033490115

  Addiction (Substance Use Disorder), SC

  Medicare reassignment NPD

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

{
    "created_epoch": "1405123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1619384583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 PERIMETER PARKWAY SUITE 200 - #0425",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28216",
            "telephone_number": "980-230-8880",
            "fax_number": "844-841-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 PERIMETER PARKWAY SUITE 200 - #0425",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28216",
            "telephone_number": "980-230-8880",
            "fax_number": "844-841-1302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 E Main St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297305383",
            "country_code": "US",
            "telephone_number": "980-230-8880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNER TRANSFORMATION THERAPEUTIC SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-12",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CORRELIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-230-8880",
        "authorized_official_credential": "LCSW, LISW-CP, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INNER TRANSFORMATION THERAPEUTIC SERVICES, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "INNER TRANSFORMATION THERAPEUTIC SERVICES, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.