Individual provider Active NPI

Kendall Clay

  • Professional Counselor
  • Mooresville, NC
National Provider Identifier
1063110450
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A18465 Issued in NC
Practice address
311 Williamson Rd Ste 103
Mooresville, NC 28117-5967
Phone
(704) 360-3049
NPI assigned
Feb 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A18465 NC Primary

Addresses

Primary practice location

311 Williamson Rd Ste 103
Mooresville, NC 28117-5967

Mailing address

13717 Reese Blvd W Apt 304
Huntersville, NC 28078-6087
Phone (910) 604-4589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A18465NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling and Wellness, PLLC Professional CurrentSince Feb 19, 2023 Accepting new patients

Locations

311 Williamson Rd
Ste 103
Mooresville, NC 28117
Phone (704) 360-3049

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1063110450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13717 REESE BLVD W APT 304",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786087",
            "telephone_number": "910-604-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WILLIAMSON RD STE 103",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175967",
            "telephone_number": "704-360-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "KENDALL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A18465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.