NPIMap

Organization Active NPI

Self Concepts Clinical Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Gastonia, NC
National Provider Identifier
1902967862
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SELF CONCEPTS CLINICAL COUNSELING SERVICES, INC.
Practice address
1305 E. Garrison Blvd.
Gastonia, NC 28054-5127
Phone
(704) 852-3874
Fax
(704) 852-7060
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Authorized official

Name
Ms. Melissa A Williams, LPC/LCAS/CCSNPI 1881755452
Title
Ceo/President
Phone
(704) 852-3874

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1305 E. Garrison Blvd.
Gastonia, NC 28054-5127

Mailing address

PO Box 2543
Gastonia, NC 28053-2543
Phone (704) 852-3874

Other identifiers 2

IdentifierTypeStateIssuer
6005253MedicaidNC
8300519MedicaidNC

National Provider Directory

National Provider Directory

Locations

1305 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 852-3874

Practitioners & affiliated clinicians

Practitioners 2

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1902967862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2543",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280532543",
            "telephone_number": "704-852-3874",
            "fax_number": "704-852-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 E. GARRISON BLVD.",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545127",
            "telephone_number": "704-852-3874",
            "fax_number": "704-852-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF CONCEPTS CLINICAL COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "704-852-3874",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC/LCAS/CCS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005253",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300519",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.