Individual provider Active NPI

Annie Aaliyah Bond-Richardson, M.ED, LCMHCA, NCC

  • Mental Health Counselor
  • Concord, NC
National Provider Identifier
1073186508
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A16750 Issued in NC
Practice address
280 Executive Park Dr Ste 100
Concord, NC 28025-1838
Phone
(704) 237-4240
NPI assigned
Jul 22, 2021
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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 A16750 NC Primary

Addresses

Primary practice location

280 Executive Park Dr Ste 100
Concord, NC 28025-1838

Mailing address

873 Willow Wood LN Apt 202
Rock Hill, SC 29730-0126
Phone (662) 695-0559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A16750NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1073186508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "873 WILLOW WOOD LN APT 202",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297300126",
            "telephone_number": "662-695-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251838",
            "telephone_number": "704-237-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOND-RICHARDSON",
        "first_name": "ANNIE",
        "middle_name": "AALIYAH",
        "credential": "M.ED, LCMHCA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.