Healthcare Provider Details

I. General information

NPI: 1235053414
Provider Name (Legal Business Name): SOUND MIND AUTHORITY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 SIENNA HEIGHTS PL
CHARLOTTE NC
28213-3168
US

IV. Provider business mailing address

7441 SIENNA HEIGHTS PL
CHARLOTTE NC
28213-3168
US

V. Phone/Fax

Practice location:
  • Phone: 910-214-2981
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JOCELYN ALISA SAMPSON
Title or Position: FOUNDER
Credential: LCSW
Phone: 910-214-2981