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SOUTHPORT COUNSELING SERVICES, PLLC
NPI 1942776943
Social Worker - Clinical in Southport, NC

Active since October 17, 2018
3960 EXECUTIVE PARK BLVD STE 3, SOUTHPORT, NC 28461(910) 854-0371(910) 854-0371 Get Directions Write a Review

NPPES record last updated: October 17, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southport Counseling Services, Pllc NPPES

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

SOUTHPORT COUNSELING SERVICES, PLLC (NPI 1942776943) is a healthcare organization registered as a clinical in Southport, North Carolina and active in the NPI registry since October 2018. The organization lists Kymra F Stewart, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1942776943
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameSOUTHPORT COUNSELING SERVICES, PLLC
Location Address3960 EXECUTIVE PARK BLVD STE 3Southport, NC 28461-8184
Mailing Address3960 Executive Park Blvd Ste 3Southport, NC 28461-8184 · (910) 854-0371 · Fax (910) 854-0371
Phone(910) 854-0371
Fax(910) 854-0371
Organization SubpartNo
Authorized OfficialKymra F StewartProvider/owner · (828) 385-1889
Enumeration DateOctober 17, 2018
✔ NPI 1942776943 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.
3960 EXECUTIVE PARK BLVD STE 3, Southport, NC 28461
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Other Identifiers 1

Other79895NC · Bcbsnc

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 SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southport Counseling Services, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southport Counseling Services, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kymra Stewart, LCSW
Clinical Social Worker
NPI 1053348177
3960 EXECUTIVE PARK BLVD STE 3
Southport, NC 28461
(910) 854-0371
✔ PECOS✔ Accepts MedicareSame address

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 Southport Counseling Services, PLLC's NPI number?

The NPI number for Southport Counseling Services, PLLC is 1942776943. It was assigned to this organization in the NPPES registry on October 17, 2018.

Where is Southport Counseling Services, PLLC located?

Southport Counseling Services, PLLC is located at 3960 Executive Park Blvd Ste 3, Southport, NC 28461. The listed phone number is (910) 854-0371.

What is Southport Counseling Services, PLLC's specialty?

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

Is Southport Counseling Services, PLLC enrolled in Medicare?

Yes. Southport Counseling Services, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southport Counseling Services, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Southport Counseling Services, PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southport Counseling Services, PLLC was last updated on October 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.