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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLACK SERENE, PLLC
NPI 1184472573
Counselor - Mental Health in Charlotte, NC

Active since May 09, 2024
10130 MALLARD CREEK RD STE 300, CHARLOTTE, NC 28262(404) 649-5274(404) 726-4881 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 6, 2026, Mar 24, 2026, Sep 20, 2025 and 3 more (6 updates tracked since 2024).

About Black Serene, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK SERENE, PLLC (NPI 1184472573) is a healthcare organization registered as a mental health in Charlotte, North Carolina and active in the NPI registry since May 2024. The organization lists Dazzmen Nikole Davis, Practice Owner/licensed Counselor, as its authorized official.

NPPES Registry Identity

NPI1184472573
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameBLACK SERENE, PLLC
Location Address10130 MALLARD CREEK RD STE 300Charlotte, NC 28262-6001
Mailing Address10130 Mallard Creek Rd Ste 300Charlotte, NC 28262-6001 · (404) 649-5274 · Fax (404) 726-4881
Phone(404) 649-5274
Fax(404) 726-4881
Organization SubpartNo
Authorized OfficialDazzmen Nikole DavisPractice Owner/licensed Counselor · (404) 649-5274
Enumeration DateMay 9, 2024
Last NPPES UpdateOctober 20, 20266 updates tracked since enumeration
NPPES CertifiedOctober 20, 2026
✔ NPI 1184472573 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
10130 MALLARD CREEK RD STE 300, Charlotte, NC 28262
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TERRI LYNN TILFORD EDD
Counselor (Professional)
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (980) 689-4127
JENNIFER HUGE LCMHCA
Counselor (Professional)
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (704) 944-3533
TYLEA WHITE
Social Worker (Clinical)
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (704) 944-3533
TAUSI KIDS FOUNDATION INC
Foster Care Agency
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (704) 944-5554
SUPPORTING PEOPLE IN NEED - SPIN
Social Worker (Clinical)
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (980) 253-1924
AMBER KIMBLE LCSW
Social Worker (Clinical)
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (980) 225-1585
NEW PHASE CHRISTIAN COUNSELING & RESTORATION CENTER,PLLC
Counselor (Mental Health)
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (704) 944-3530
RESTORE MENTAL HEALTH PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
10130 MALLARD CREEK RD STE 300
CHARLOTTE, NC 28262
Mecklenburg County (704) 550-8414

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Black Serene, PLLC's NPI number?

The NPI number for Black Serene, PLLC is 1184472573. It was assigned to this organization in the NPPES registry on May 9, 2024.

Where is Black Serene, PLLC located?

Black Serene, PLLC is located at 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262. The listed phone number is (404) 649-5274.

What is Black Serene, PLLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Black Serene, PLLC was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.