NPIMap

Organization Active NPI

Solid Mind Therapy, PLLC

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1831978162
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SOLID MIND THERAPY, PLLC
Practice address
10211 Brokers Tip LN Apt 305
Raleigh, NC 27617-6219
Phone
(404) 234-9635
NPI assigned
Sep 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Priscilla L Jacko, LCMHC, NCCNPI 1821336546
Title
Owner/Counselor
Phone
(404) 234-9635

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

10211 Brokers Tip LN Apt 305
Raleigh, NC 27617-6219

Mailing address

10211 Brokers Tip LN Apt 305
Raleigh, NC 27617-6219
Phone (404) 234-9635

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1831978162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 BROKERS TIP LN APT 305",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276176219",
            "telephone_number": "404-234-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 BROKERS TIP LN APT 305",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276176219",
            "telephone_number": "404-234-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLID MIND THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "JACKO",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "404-234-9635",
        "authorized_official_credential": "LCMHC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.