NPIMap

Organization Active NPI

Triquetra Counseling, PLLC

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1790435600
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TRIQUETRA COUNSELING, PLLC
Practice address
3926 Miriam Dr
Charlotte, NC 28205-7726
Phone
(704) 476-1580
NPI assigned
Mar 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Authorized official

Name
Sabina Maria Klein, LCMHCNPI 1770106163
Title
Owner, Therapist
Phone
(704) 476-1580

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3926 Miriam Dr
Charlotte, NC 28205-7726

Mailing address

3926 Miriam Dr
Charlotte, NC 28205-7726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260408000581 NC Part B Supplier - Clinic/Group Practice 2365917309 Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory
Tax ID family
Triquetra Counseling PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3926 Miriam Dr
Charlotte, NC 28205
Phone (704) 476-1580

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1790435600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3926 MIRIAM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3926 MIRIAM DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057726",
            "telephone_number": "704-476-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIQUETRA COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "SABINA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "704-476-1580",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.