Independence Counseling and Consulting Services, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7366 Issued in NC

Legal business name

INDEPENDENCE COUNSELING AND CONSULTING SERVICES, PLLC

Practice address

946 Mockingbird Hill Rd
Raeford, NC 28376-6363

Phone

(910) 261-4635

NPI assigned

Dec 19, 2012

Last updated

Dec 19, 2012By 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

Tiffany Shaw, LPC, NCC, LCASNPI 1063649374

Title

Director

Phone

(910) 261-4635

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Tiffany Sheree Shaw, LCMHC,LPC, NCC, LCAS

  • Professional Counselor
  • Fort Lee, VA
  • NPI 1063649374

  Mental Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1932445996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 MOCKINGBIRD HILL RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283766363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 MOCKINGBIRD HILL RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283766363",
            "telephone_number": "910-261-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE COUNSELING AND CONSULTING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-261-4635",
        "authorized_official_credential": "LPC, NCC, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kourtney Monshae Humes
• Erin M Hunt Gist
• Patrick Scott Hurley, P.A
• Tekaria Hurley
• Kara Rose Ickes
• Charles Thomas Inman, OD
• Innovative Therapeutic Services
• Integrated Mental Health Services Agency Inc
• Integrity-Open Arms, LLC (Open Arms Retirement Center)
• Brittany Isaac, LCSWA

• Mental Health Counselor in Raeford, NC
• Providers in Raeford, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.