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PROVISIONS COUNSELING SERVICES
NPI 1457861072
Counselor in Charlotte, NC

Active since October 10, 2017
1000 BAXTER ST, CHARLOTTE, NC 28204(704) 750-0655 Get Directions Write a Review

NPPES record last updated: December 6, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 6, 2017, Oct 10, 2017 (2 updates tracked since 2017).

About Provisions Counseling Services NPPES

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

PROVISIONS COUNSELING SERVICES (NPI 1457861072) is a healthcare organization registered as a counselor in Charlotte, North Carolina and active in the NPI registry since October 2017. The organization lists Shiricka Lashaye Fair, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1457861072
Entity TypeOrganization
Primary Taxonomy101Y00000X
Legal Business NamePROVISIONS COUNSELING SERVICES
Location Address1000 BAXTER STCharlotte, NC 28204-2859
Mailing Address5115 Mintvale DrCharlotte, NC 28269-1689 · (704) 750-0655
Phone(704) 750-0655
Organization SubpartNo
Authorized OfficialShiricka Lashaye FairExecutive Director · (704) 750-0655
Enumeration DateOctober 10, 2017
Last NPPES UpdateDecember 6, 20172 updates tracked since enumeration
✔ NPI 1457861072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in NC · 1484
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License 1484 (NC)
1000 BAXTER ST, Charlotte, NC 28204
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Other Identifiers 1

Medicaid1326339185NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

BLAKE RESOURCES LLC
Community/Behavioral Health
1000 BAXTER ST
CHARLOTTE, NC 28204
Mecklenburg County (704) 231-3191
INNERVISION INC.
Community/Behavioral Health
1000 BAXTER ST
CHARLOTTE, NC 28204
Mecklenburg County (704) 377-5047
WINGS GROUP HOME LLC
Community/Behavioral Health
1000 BAXTER ST
CHARLOTTE, NC 28204
Mecklenburg County (704) 449-2309

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 Provisions Counseling Services's NPI number?

The NPI number for Provisions Counseling Services is 1457861072. It was assigned to this organization in the NPPES registry on October 10, 2017.

Where is Provisions Counseling Services located?

Provisions Counseling Services is located at 1000 Baxter St, Charlotte, NC 28204. The listed phone number is (704) 750-0655.

What is Provisions Counseling Services's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Provisions Counseling Services was last updated on December 6, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.