Michael Clark-Borenstein

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13607 Issued in NC

Practice address

3800 Meeting St Ste 230
Indian Trail, NC 28079-6582

Phone

(704) 237-0705

Fax

(980) 236-1356

NPI assigned

Mar 18, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bright View Counseling PLLC

  • Mental Health Counselor
  • Indian Trail, NC
  • NPI 1063188548
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1003319807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 MEETING ST STE 230",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280796582",
            "telephone_number": "704-237-0705",
            "fax_number": "980-236-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 MEETING ST STE 230",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280796582",
            "telephone_number": "704-237-0705",
            "fax_number": "980-236-1356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15805 Fairfield Dr",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281042211",
            "country_code": "US",
            "telephone_number": "704-237-0705",
            "fax_number": "980-236-1356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10800 Sikes Pl Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282778124",
            "country_code": "US",
            "telephone_number": "731-270-4995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK-BORENSTEIN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-18",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A13607",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.