Daniel Baucom, MA, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A20266 Issued in NC

Practice address

4730 Park Rd Ste a
Charlotte, NC 28209-4205

Phone

(704) 800-4436

NPI assigned

Aug 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Modern Era Counseling, PLLC

  • Professional Counselor
  • Charlotte, NC
  • NPI 1518508340

  Mental Health

  NPD

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1093549495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 JACKSON ST",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280527555",
            "telephone_number": "704-860-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 PARK RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094205",
            "telephone_number": "704-800-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUCOM",
        "first_name": "DANIEL",
        "credential": "MA, LCMHCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Anne Battles, DC
• Jayne J Batts, MD
• Stanley Adam Batts, LIC. OPTICIAN
• Ashleigh Baucom, NP
• Courtney Baucom
• Jo Anne Baucom, LPTA
• Kimberley M Baucom
• Daniel Roy Bauer, M.D.
• Kaylen Buckner Bauer
• Kenneth Robert Bauer, D.C.

• All providers in Charlotte, NC
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.