NPIMap

Organization Active NPI

Anderson Counseling and Consulting Group, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1629416029
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
9371 Issued in NC
Legal business name
ANDERSON COUNSELING AND CONSULTING GROUP, PLLC
Practice address
1923 J N Pease PL Ste 104
Charlotte, NC 28262-4534
Phone
(704) 208-4458
Fax
(866) 309-6385
NPI assigned
Jun 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Mr. Rulondo Tehran Anderson Sr., LCMHCNPI 1356577308
Title
Owner/ Clinical Therapist
Phone
(704) 252-4381

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 9371 NC
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Community/Behavioral Health Agency 251S00000X 9371 NC Primary

Addresses

Primary practice location

1923 J N Pease PL Ste 104
Charlotte, NC 28262-4534

Mailing address

2013 Beechmont St
Harrisburg, NC 28075-8365
Phone (704) 208-4458

Other practice location 1

2315 E Wt Harris Blvd Ste 102
Charlotte, NC 28213-5133
Phone (704) 208-4458

Other identifiers 1

IdentifierTypeStateIssuer
6115004MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240314000284 NC Part B Supplier - Clinic/Group Practice 5496191389 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

8401 Medical Plaza Dr
Ste 360
Charlotte, NC 28262
Phone (704) 208-4458

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1629416029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 BEECHMONT ST",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280758365",
            "telephone_number": "704-208-4458",
            "fax_number": "866-309-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 J N PEASE PL STE 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624534",
            "telephone_number": "704-208-4458",
            "fax_number": "866-309-6385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 E Wt Harris Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282135133",
            "country_code": "US",
            "telephone_number": "704-208-4458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANDERSON COUNSELING AND CONSULTING GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RULONDO",
        "authorized_official_middle_name": "TEHRAN",
        "authorized_official_title_or_position": "OWNER/ CLINICAL THERAPIST",
        "authorized_official_telephone_number": "704-252-4381",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "9371",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "9371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6115004",
            "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 Mar 4, 2021; 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.