Organization · Type 2 NPI

Southpark Psychotherapy PLLC

Mental Health Counselor · Charlotte, NC

NPI number 1679285043 Active

Practice location

5950 Fairview Rd Ste 770
Charlotte, NC 28210-3142

Fax (980) 980-5841

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1679285043

Southpark Psychotherapy PLLC's National Provider Identifier is 1679285043, issued on Dec 19, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Charlotte, NC. The record was last updated on Oct 20, 2026.