Individual provider Active NPI

Melissa Cummins

  • Mental Health Counselor
  • Mooresville, NC
National Provider Identifier
1093282584
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
862 Brawley School Rd Ste 202
Mooresville, NC 28117-8154
Phone
(704) 659-4707
Fax
(980) 444-3841
NPI assigned
Nov 1, 2018
Last updated
Aug 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 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 NU Primary

Addresses

Primary practice location

862 Brawley School Rd Ste 202
Mooresville, NC 28117-8154

Mailing address

13420 Reese Blvd W
Huntersville, NC 28078-7925
Phone (704) 266-4208

Other practice location 1

13420 Reese Blvd W
Huntersville, NC 28078-7925
Phone (704) 266-4208

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
14468NCMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1093282584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13420 REESE BLVD W",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787925",
            "telephone_number": "704-266-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 BRAWLEY SCHOOL RD STE 202",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178154",
            "telephone_number": "704-659-4707",
            "fax_number": "980-444-3841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13420 Reese Blvd W",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787925",
            "country_code": "US",
            "telephone_number": "704-266-4208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMMINS",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.