SOUTHLAKE CENTER FOR SELF DISCOVERY
NPI 1366656910
Social Worker - Clinical in Davidson, NC

Active since May 10, 2007
903 NORTHEAST DR STE 201, DAVIDSON, NC 28036(704) 896-7776(704) 896-0992 Get Directions Write a Review

NPPES record last updated: June 23, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southlake Center For Self Discovery NPPES

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

SOUTHLAKE CENTER FOR SELF DISCOVERY (NPI 1366656910) is a healthcare organization registered as a clinical in Davidson, North Carolina and active in the NPI registry since May 2007. The organization lists Kimberly Krueger, Owner Director, as its authorized official.

NPPES Registry Identity

NPI1366656910
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameSOUTHLAKE CENTER FOR SELF DISCOVERY
Location Address903 NORTHEAST DR STE 201Davidson, NC 28036-7438
Mailing Address903 Northeast Dr Ste 201Davidson, NC 28036-7438 · (704) 896-7776 · Fax (704) 896-0992
Fax(704) 896-0992
Organization SubpartNo
Authorized OfficialKimberly KruegerOwner Director · (704) 896-7776
Enumeration DateMay 10, 2007
Last NPPES UpdateJune 23, 2009
NPI 1366656910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
903 NORTHEAST DR STE 201, Davidson, NC 28036

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 15

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

Counselor (Mental Health)
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036
Counselor (Mental Health)
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036
Counselor (Mental Health)
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036
Social Worker (Clinical)
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036
Social Worker (Clinical)
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036
Counselor (Mental Health)
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036
Counselor (Mental Health)
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036
Marriage & Family Therapist
903 NORTHEAST DR STE 201
DAVIDSON, NC 28036

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 Southlake Center For Self Discovery's NPI number?

The NPI number for Southlake Center For Self Discovery is 1366656910. It was assigned to this organization in the NPPES registry on May 10, 2007.

Where is Southlake Center For Self Discovery located?

Southlake Center For Self Discovery is located at 903 Northeast Dr Ste 201, Davidson, NC 28036. The listed phone number is (704) 896-7776.

What is Southlake Center For Self Discovery's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Southlake Center For Self Discovery was last updated on June 23, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.