MEDICARE: SHIDEH SARMADI LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2347	SC
2	101YP2500X	Professional Counselor	0701005209	VA

General Provider Information

NPI Number	:	1073521415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIDEH SARMADI LPC

Provider Business Mailing Address
First Line	:	BEHAVIORAL HEALTH CENTER CMC RANDOLPH
Second Line	:	501 BILLINGSLEY ROAD
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1009
Country	:	US
Telephone Number	:	704-358-2700
Fax Number	:	704-358-2938

Provider Business Practice Location Address
First Line	:	BEHAVIORAL HEALTH CENTER CMC RANDOLPH
Second Line	:	501 BILLINGSLEY ROAD
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1009
Country	:	US
Telephone Number	:	704-358-2700
Fax Number	:	704-358-2716

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	05/13/2026

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