Waystation Counseling PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WAYSTATION COUNSELING PLLC

Practice address

4724 Park Rd Ste a
Charlotte, NC 28209-4204

Phone

(704) 218-9083

Fax

(980) 237-7512

NPI assigned

Jun 30, 2020

Organization subpart

No

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

Authorized official

Name

Julie Kornowski

Title

Cfo

Phone

(920) 360-0116

Specialties & licenses 1

Addresses

Other names 2

• Patricia Lockhart Former legal business name
• Waystation Counseling and Wellness Center Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Lockhart, MSW LCSW

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1780050450
  NPD

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1972120558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4724 PARK RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094204",
            "telephone_number": "704-218-9083",
            "fax_number": "980-237-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4724 PARK RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094204",
            "telephone_number": "704-218-9083",
            "fax_number": "980-237-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYSTATION COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2021-12-27",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "KORNOWSKI",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-360-0116"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patricia Lockhart",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Waystation Counseling and Wellness Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Waystation Counseling and Wellness Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.