Healthcare Provider Details

I. General information

NPI: 1437613643
Provider Name (Legal Business Name): LSJ COUNSELING AND CLINICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 J N PEASE PL STE 103
CHARLOTTE NC
28262-4509
US

IV. Provider business mailing address

1905 J N PEASE PL STE 103
CHARLOTTE NC
28262-4509
US

V. Phone/Fax

Practice location:
  • Phone: 704-910-0136
  • Fax: 866-800-2456
Mailing address:
  • Phone: 704-910-0136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LAKESHA SHINGLER HOWELL
Title or Position: CLINICAL DIRECTOR
Credential: LCSW, LCAS
Phone: 704-910-0136