Obasi Jaheem Amare Jr., LCMHC
Individual provider Active NPI Mental Health Counselor · Charlotte, NC
NPI 1104377076 · NPPES record last updated May 5, 2025
Key facts
- NPI
- 1104377076
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 12571 (NC)
- Practice address
- 1942 E 7TH St Ste 220
Charlotte, NC 28204-2418 - Phone
- (704) 360-3637
- NPI assigned
- Oct 17, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Integrative Wellness Solutions PLLC
Practice addresses (Care Compare)
1942 E 7TH St
Suite 220
Charlotte, NC 28204-2418
Phone (704) 360-3637
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250523002738 | NC | Practitioner - Mental Health Counselor | 9133648942 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12571 | NC | MD | Mental Health Counselor |
| A12571 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Wellness Solutions, PLLC | Mental Health | Current |
Accepting new patients |
| Preferred Choice Healthcare | Mental Health | Past | Accepting new patients |
Locations
1942 E 7th St
Ste 220
Charlotte, NC 28204
Phone (704) 777-0693
10430 Harris Oak Blvd
Ste L
Charlotte, NC 28269
Phone (704) 317-2930
3625 N Elm St
Ste 130
Greensboro, NC 27455
122 Gateway Blvd
Ste C
Mooresville, NC 28117
Phone (980) 766-1030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A12571 | NC | |
| Professional Counselor | 101YP2500X | 12571 | NC | |
| Mental Health Counselor | 101YM0800X | 12571 | NC | Yes |
Addresses
Primary practice location
1942 E 7TH St Ste 220
Charlotte, NC 28204-2418
Mailing address
1942 E 7TH St Ste 220
Charlotte, NC 28204-2418
Phone (704) 360-3637
Other providers in Charlotte, NC
- Amara Pain & Spine PLLC
- Amara Wellness Services, Inc
- Ashvin Amara
- Alexis Pamela Amaral
- Amara Shanthi Amarasinghe
- Hallie Rose Amat
- Khrysthale Hayatt Amaya
- Amazing Grace Home Healthcare LLC
- Lusine Rafaelovna Ambartsumyan
- Saritha Ambati
All providers in Charlotte, NC · Mental Health Counselor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.