Individual provider Active NPI

Tammy McDonald

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1114342904
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2202 Wrightsville Ave
Ste 113
Wilmington, NC 28403-3051
Phone
(910) 791-5757
Fax
(910) 251-5893
NPI assigned
Mar 3, 2014
Last updated
Mar 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2202 Wrightsville Ave
Ste 113
Wilmington, NC 28403-3051

Mailing address

PO Box 509
Castle Hayne, NC 28429-0509
Phone (910) 791-5757

Other identifiers 1

IdentifierTypeStateIssuer
6008126MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
True Balance Therapy & Life Coaching Mental Health Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1114342904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "CASTLE HAYNE",
            "state": "NC",
            "postal_code": "284290509",
            "telephone_number": "910-791-5757",
            "fax_number": "910-251-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 WRIGHTSVILLE AVE",
            "address_2": "STE 113",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033051",
            "telephone_number": "910-791-5757",
            "fax_number": "910-251-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TAMMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008126",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.