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SOUTHPARK PSYCHOTHERAPY PLLC
NPI 1679285043
Counselor - Mental Health in Charlotte, NC

Active since December 19, 2022
5950 FAIRVIEW RD STE 770, CHARLOTTE, NC 28210(980) 999-0501(980) 980-5841 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 15, 2026, Nov 10, 2024, Jul 31, 2024 and 3 more (6 updates tracked since 2022).

About Southpark Psychotherapy Pllc NPPES

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

SOUTHPARK PSYCHOTHERAPY PLLC (NPI 1679285043), doing business as Southpark Psychotherapy, is a healthcare organization registered as a mental health in Charlotte, North Carolina and active in the NPI registry since December 2022. The organization lists Sara Elizabeth Wilkerson, Counselor And Owner, as its authorized official.

NPPES Registry Identity

NPI1679285043
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameSOUTHPARK PSYCHOTHERAPY PLLC
Location Address5950 FAIRVIEW RD STE 770Charlotte, NC 28210-3142
Mailing Address5950 Fairview Rd Ste 770Charlotte, NC 28210-3142 · (980) 999-0501 · Fax (980) 980-5841
Phone(980) 999-0501
Fax(980) 980-5841
Organization SubpartNo
Authorized OfficialSara Elizabeth WilkersonCounselor And Owner · (980) 999-0501
Enumeration DateDecember 19, 2022
Last NPPES UpdateJuly 15, 20266 updates tracked since enumeration
NPPES CertifiedJuly 15, 2026
✔ NPI 1679285043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
5950 FAIRVIEW RD STE 770, Charlotte, NC 28210
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Other Names 1

Doing Business AsSouthpark Psychotherapy

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southpark Psychotherapy Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Southpark Psychotherapy PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Sara Wilkerson, LCMHC
Mental Health Counselor
NPI 1528677226
5950 FAIRVIEW RD STE 770
Charlotte, NC 28210
(980) 999-0501
✔ PECOS✔ Accepts MedicareSame address
Katherine Maynor, MSW, LCSW
Clinical Social Worker
NPI 1790346872
5821 FAIRVIEW RD STE 200
Charlotte, NC 28209
(980) 580-0639
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Southpark Psychotherapy PLLC's NPI number?

The NPI number for Southpark Psychotherapy PLLC is 1679285043. It was assigned to this organization in the NPPES registry on December 19, 2022. The provider is doing business as SouthPark Psychotherapy.

Where is Southpark Psychotherapy PLLC located?

Southpark Psychotherapy PLLC is located at 5950 Fairview Rd Ste 770, Charlotte, NC 28210. The listed phone number is (980) 999-0501.

What is Southpark Psychotherapy PLLC's specialty?

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

Is Southpark Psychotherapy PLLC enrolled in Medicare?

Yes. Southpark Psychotherapy PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southpark Psychotherapy PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Southpark Psychotherapy PLLC, in Clinical Social Worker and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southpark Psychotherapy PLLC accept?

Health plans from Blue Cross and Blue Shield of NC and Cigna Healthcare list Southpark Psychotherapy PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southpark Psychotherapy PLLC was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.