Active NPI
Stephanie Colson
- Mental Health Counselor
- Waxhaw, NC
National Provider Identifier
1093249989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 104 Waxhaw Professional Park Dr Ste D
Waxhaw, NC 28173-5020 - Phone
- (170) 467-2465
- NPI assigned
- Apr 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
104 Waxhaw Professional Park Dr Ste D
Waxhaw, NC 28173-5020
Mailing address
PO Box 31
Fort Mill, SC 29716-0031
Phone (704) 672-4655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2024 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gaines Therapy PLLC | Mental Health | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Waxhaw, NC
- NPI 1598362188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631664000000",
"number": "1093249989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297160031",
"telephone_number": "704-672-4655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 WAXHAW PROFESSIONAL PARK DR STE D",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281735020",
"telephone_number": "170-467-2465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLSON",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-18",
"last_updated": "2021-09-15",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.