Individual provider Active NPI

Sydney Ellesse Kauffman, LCMHC-A

  • Mental Health Counselor
  • Salisbury, NC
National Provider Identifier
1639983109
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A20686 Issued in NC
Practice address
1933 Jake Alexander Blvd W Ste 102
Salisbury, NC 28147-1157
Phone
(704) 762-0074
NPI assigned
Feb 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A20686 NC Primary

Addresses

Primary practice location

1933 Jake Alexander Blvd W Ste 102
Salisbury, NC 28147-1157

Mailing address

2728 Wingdale Dr
Charlotte, NC 28213-5269
Phone (251) 424-7768

Other names 1

  • Sydney Ellesse Sain Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A20686NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Days Counseling Services Mental Health CurrentSince Feb 9, 2025 Accepting new patients

Locations

1933 Jake Alexander Blvd W
Ste 102
Salisbury, NC 28147
Phone (704) 762-0074

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1639983109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 WINGDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135269",
            "telephone_number": "251-424-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 JAKE ALEXANDER BLVD W STE 102",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471157",
            "telephone_number": "704-762-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "SYDNEY",
        "middle_name": "ELLESSE",
        "credential": "LCMHC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYDNEY",
            "last_name": "SAIN",
            "middle_name": "ELLESSE",
            "credential": "LCMHC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.