Individual provider Active NPI

Alexandra Mott, M.ED., ED.S., LPC

  • Mental Health Counselor
  • Greenville, SC
National Provider Identifier
1043883796
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1990 Augusta St Ste 400
Greenville, SC 29605-6509
Phone
(864) 660-3453
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1990 Augusta St Ste 400
Greenville, SC 29605-6509

Mailing address

1990 Augusta St Ste 400
Greenville, SC 29605-6509
Phone (864) 660-3453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2025 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
9091SCMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Revive & Renew Counseling, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1990 Augusta St
Ste 400
Greenville, SC 29605
Phone (864) 660-3453

1990 Augusta St
Ste 800
Greenville, SC 29605

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1043883796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 AUGUSTA ST STE 400",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296056509",
            "telephone_number": "864-660-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 AUGUSTA ST STE 400",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296056509",
            "telephone_number": "864-660-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTT",
        "first_name": "ALEXANDRA",
        "credential": "M.ED., ED.S., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.