Healthcare Provider Details

I. General information

NPI: 1083536312
Provider Name (Legal Business Name): GRATITUDE COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10926 DAVID TAYLOR DR STE 120
CHARLOTTE NC
28262
US

IV. Provider business mailing address

10850 PROVIDENCE RD # 1323
CHARLOTTE NC
28277-2684
US

V. Phone/Fax

Practice location:
  • Phone: 980-351-8006
  • Fax: 980-206-9727
Mailing address:
  • Phone: 980-351-8006
  • Fax: 980-206-9727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH RILEY
Title or Position: MENTAL HEALTH COUNSELOR
Credential: MA, LCMHC, NCC
Phone: 864-230-8197