NPIMap

Organization Active NPI

Carolina Therapeutic Services Community Development Inc

  • Family Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1649050345
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC
Practice address
1781 Tate Blvd SE Ste 202
Hickory, NC 28602-4252
Phone
(828) 758-1320
Fax
(828) 758-1332
NPI assigned
Oct 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Holly Shivadecker
Title
Cfo
Phone
(704) 864-1477

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1781 Tate Blvd SE Ste 202
Hickory, NC 28602-4252

Mailing address

1528 Union Rd
Gastonia, NC 28054-2200
Phone (704) 864-1477

Other names 1

  • CTSCD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carolina Therapeutic Services Community Development Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1649050345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 UNION RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542200",
            "telephone_number": "704-864-1477",
            "fax_number": "704-396-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 TATE BLVD SE STE 202",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024252",
            "telephone_number": "828-758-1320",
            "fax_number": "828-758-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "SHIVADECKER",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-864-1477"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CTSCD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.