Prominence Consulting & Theraputic Services LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1577 Issued in NC

Legal business name

PROMINENCE CONSULTING & THERAPUTIC SERVICES LLC

Practice address

4909 Waters Edge Dr
204
Raleigh, NC 27606-2462

Phone

(919) 841-8679

NPI assigned

Feb 17, 2014

Organization subpart

No

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

Authorized official

Name

Courtney Strickland, MSW, LCAS, LCSWA,

Title

Executive Director

Phone

(919) 841-8679

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1649694357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR",
            "address_2": "204",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-841-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR",
            "address_2": "204",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-841-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMINENCE CONSULTING & THERAPUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-17",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "STRICKLAND",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-841-8679",
        "authorized_official_credential": "MSW, LCAS, LCSWA,"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1577",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "1577",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112149",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; 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.