Clearwaters Counseling Services, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

MHL-077-081 Issued in NC

Legal business name

CLEARWATERS COUNSELING SERVICES, LLC

Doing business as

Clearwaters Counseling Services, LLC

Practice address

34 W Main St
Hamlet, NC 28345-3636

Phone

(170) 447-5644

Fax

(910) 448-9008

NPI assigned

May 31, 2018

Last updated

May 31, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shirley W. Liles, CPSS

Title

Corporate Compliance Officer

Phone

(704) 695-2391

Specialties & licenses 1

Addresses

Other names 1

• Clearwaters Counseling Services, LLC Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Clearwaters Counseling Services, LLC

  • Mental Health Counselor
  • Hamlet, NC
  • NPI 1396257085
  NPPES parent name

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1770075368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 W MAIN ST",
            "city": "HAMLET",
            "state": "NC",
            "postal_code": "283453636",
            "telephone_number": "170-447-5644",
            "fax_number": "910-448-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 W MAIN ST",
            "city": "HAMLET",
            "state": "NC",
            "postal_code": "283453636",
            "telephone_number": "170-447-5644",
            "fax_number": "910-448-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATERS COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "LILES",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CORPORATE COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "704-695-2391",
        "authorized_official_credential": "CPSS"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "MHL-077-081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearwaters Counseling Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clearwaters Counseling Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• C & Q Transportation
• Datwon Deshawn Canty, MS, LCAS
• Cardinal Clinic LLC
• Havanna Holfert Carter, FNP-BC
• Clearwaters Counseling Services, LLC
• William Nall Cleveland, DDS
• William Raymond Comeau, M.D.
• Comforting Solutions LLC
• Continuum II Home Health & Hospice, Inc. (Continuum Home Care of Hamlet)
• Susan Lill Craven, NP

• Professional Counselor in Hamlet, NC
• Providers in Hamlet, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.