Active NPI
Everbloom Behavioral Health LLC
- Community/Behavioral Health Agency
- Charlotte, NC
National Provider Identifier
1861301400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- EVERBLOOM BEHAVIORAL HEALTH LLC
- Practice address
- 1204 Oakdale Commons CT
Charlotte, NC 28216-5811 - Phone
- (704) 953-7937
- NPI assigned
- Sep 1, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shaqueta Crowder, LCSWA
- Title
- Co-Owner
- Phone
- (704) 953-7937
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1204 Oakdale Commons CT
Charlotte, NC 28216-5811
Mailing address
1204 Oakdale Commons CT
Charlotte, NC 28216-5811
Phone (704) 953-7937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788220800000",
"number": "1861301400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 OAKDALE COMMONS CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282165811",
"telephone_number": "704-953-7937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 OAKDALE COMMONS CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282165811",
"telephone_number": "704-953-7937"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERBLOOM BEHAVIORAL HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-01",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A",
"authorized_official_last_name": "CROWDER",
"authorized_official_first_name": "SHAQUETA",
"authorized_official_title_or_position": "CO-OWNER",
"authorized_official_telephone_number": "704-953-7937",
"authorized_official_credential": "LCSWA"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"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 Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.