Individual provider Active NPI

Nicole Schultes, LPC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1104522382
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH21839 Issued in FL
Practice address
501 Billingsley Rd Ste B
Charlotte, NC 28211-1009
Phone
(561) 312-5850
NPI assigned
Jan 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC014520 GA
Mental Health Counselor 101YM0800X MH21839 FL Primary

Addresses

Primary practice location

501 Billingsley Rd Ste B
Charlotte, NC 28211-1009

Mailing address

501 Billingsley Rd Ste B
Charlotte, NC 28211-1009
Phone (561) 312-5850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260306000772 GA Practitioner - Mental Health Counselor 7315429420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

420 E 2ND Ave
Suite 103
Rome, GA 30161-3210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH21839FLMDMental Health Counselor
LPC014520GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc CurrentSince Feb 1, 2026 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Feb 1, 2026 Accepting new patients
Lifestream Behavioral Center Inc PastSince Feb 8, 2023 Accepting new patients
Lifestream Behavioral Center Inc PastSince Feb 8, 2023 Accepting new patients

Locations

990 Veterans Memorial Hwy NE
#A
Rome, GA 30161
Phone (706) 291-4100

Organizations & group practices 4

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": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1104522382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BILLINGSLEY RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "561-312-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BILLINGSLEY RD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "561-312-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTES",
        "first_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC014520",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.