Individual provider Active NPI

Michael Gisser, MFT

  • Mental Health Counselor
  • Cary, NC
National Provider Identifier
1104391192
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1140 Kildaire Farm Rd
Ste 206
Cary, NC 27511-4597
Phone
(336) 825-5433
NPI assigned
Oct 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1140 Kildaire Farm Rd
Ste 206
Cary, NC 27511-4597

Mailing address

442 Granite Mill Blvd
Chapel Hill, NC 27516-4569
Phone (336) 825-5433

Other practice location 1

152 Capcom Ave Ste 100
Wake Forest, NC 27587-6586
Phone (919) 590-5858

Other practice location 2

1140 Kildaire Farm Rd
Ste 206
Cary, NC 27511-4597
Phone (336) 825-5433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 8, 2024 through May 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2216NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mig Counseling PC CurrentSince Jun 15, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1104391192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 GRANITE MILL BLVD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275164569",
            "telephone_number": "336-825-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 KILDAIRE FARM RD",
            "address_2": "STE 206",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114597",
            "telephone_number": "336-825-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 Capcom Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wake Forest",
            "state": "NC",
            "postal_code": "275876586",
            "country_code": "US",
            "telephone_number": "919-590-5858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1140 KILDAIRE FARM RD",
            "address_2": "STE 206",
            "address_purpose": "LOCATION",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114597",
            "country_code": "US",
            "telephone_number": "336-825-5433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GISSER",
        "first_name": "MICHAEL",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.