Provider Demographics
NPI:1437613643
Name:LSJ COUNSELING AND CLINICAL SERVICES, PLLC
Entity type:Organization
Organization Name:LSJ COUNSELING AND CLINICAL SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINGLER HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAS
Authorized Official - Phone:704-930-4341
Mailing Address - Street 1:1905 J N PEASE PL STE 103
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4509
Mailing Address - Country:US
Mailing Address - Phone:704-910-0136
Mailing Address - Fax:
Practice Address - Street 1:1905 J N PEASE PL STE 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4509
Practice Address - Country:US
Practice Address - Phone:704-910-0136
Practice Address - Fax:866-800-2456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty