NPIMap

Organization Active NPI

Carolina Center for Counseling & Clinical Services, Inc.

  • Mental Health Counselor
  • Gastonia, NC
National Provider Identifier
1689752651
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CAROLINA CENTER FOR COUNSELING & CLINICAL SERVICES, INC.
Practice address
227 Wilmot Dr
Gastonia, NC 28054-4048
Phone
(704) 861-2234
Fax
(704) 861-2235
NPI assigned
Nov 1, 2006
Last updated
Oct 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Mrs. Lynn Hammontree, BA
Title
Finance Director
Phone
(704) 861-2234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

227 Wilmot Dr
Gastonia, NC 28054-4048

Mailing address

PO Box 550178
Gastonia, NC 28055-0178
Phone (704) 861-2234

Other practice location 1

910 Roberts Dr
Gastonia, NC 28054-5804
Phone (704) 864-7911

Other identifiers 8

IdentifierTypeStateIssuer
6104153MedicaidNC
8300211MedicaidNC
6103191MedicaidNC
6115044MedicaidNC
8300211SMedicaidNC
6005311MedicaidNC
6102411MedicaidNC
6104029MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1689752651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550178",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280550178",
            "telephone_number": "704-861-2234",
            "fax_number": "704-861-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 WILMOT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544048",
            "telephone_number": "704-861-2234",
            "fax_number": "704-861-2235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Roberts Dr",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280545804",
            "country_code": "US",
            "telephone_number": "704-864-7911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINA CENTER FOR COUNSELING & CLINICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "HAMMONTREE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "704-861-2234",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104153",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300211",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103191",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6115044",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300211S",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005311",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102411",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104029",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.