Organization Active NPI

Trauma Therapy of the Carolinas LLC

Doing business as Trauma Therapy of the Carolinas

  • Mental Health Counselor
  • Huntersville, NC
National Provider Identifier
1942716808
Registry record updated Jul 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10758 Issued in NC
Legal business name
TRAUMA THERAPY OF THE CAROLINAS LLC
Doing business as
Trauma Therapy of the Carolinas
Practice address
9723 Northcross Center CT Ste L
Huntersville, NC 28078-7301
Phone
(704) 962-1924
NPI assigned
Dec 14, 2017
Last updated
Jul 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2024

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

Authorized official

Name
Iris Esther Whitlock, LPCNPI 1659785319
Title
Owner
Phone
(704) 962-1924

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 Counselor 101YM0800X 10758 NC Primary

Addresses

Primary practice location

9723 Northcross Center CT Ste L
Huntersville, NC 28078-7301

Mailing address

13717 Cinnabar PL
Huntersville, NC 28078-5342
Phone (704) 962-1924

Other identifiers 1

IdentifierTypeStateIssuer
10758OtherNCNC BOARD OF LPC

Other names 1

  • Trauma Therapy of the Carolinas Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240722000307 NC Part B Supplier - Clinic/Group Practice 8325584857 Receives reassigned benefits from 1 practitioner
Practice locations: Huntersville, NC

National Provider Directory

National Provider Directory

Locations

8207 Village Harbor Dr
Cornelius, NC 28031

9723 Northcross Center Ct
Ste L
Huntersville, NC 28078
Phone (704) 948-5009

Practitioners & affiliated clinicians

Practitioners 4

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": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720224000000",
    "number": "1942716808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13717 CINNABAR PL",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785342",
            "telephone_number": "704-962-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9723 NORTHCROSS CENTER CT STE L",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787301",
            "telephone_number": "704-962-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA THERAPY OF THE CAROLINAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A",
        "authorized_official_last_name": "WHITLOCK",
        "authorized_official_first_name": "IRIS",
        "authorized_official_middle_name": "ESTHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-962-1924",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF LPC",
            "identifier": "10758",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trauma Therapy of the Carolinas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trauma Therapy of the Carolinas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; 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.