Organization Active NPI

Crimson Wellness LLC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1710620620
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CRIMSON WELLNESS LLC
Practice address
3126 Milton Rd Ste 230
Charlotte, NC 28215-3775
Phone
(910) 434-5325
NPI assigned
Apr 18, 2022
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Tahiyya MartinNPI 1073909495
Title
Member/Founder
Phone
(704) 288-6945

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU Primary
Professional Counselor 101YP2500X NU

Addresses

Primary practice location

3126 Milton Rd Ste 230
Charlotte, NC 28215-3775

Mailing address

8322 Carob Tree LN
Charlotte, NC 28215-7142
Phone (910) 434-5325

National Provider Directory

National Provider Directory

Locations

3126 Milton Rd
Ste 230
Charlotte, NC 28215
Phone (910) 434-5325

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1710620620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8322 CAROB TREE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282157142",
            "telephone_number": "910-434-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3126 MILTON RD STE 230",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153775",
            "telephone_number": "910-434-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRIMSON WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TAHIYYA",
        "authorized_official_title_or_position": "MEMBER/FOUNDER",
        "authorized_official_telephone_number": "704-288-6945"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 May 25, 2022; 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.