Individual provider Active NPI

Melissa Ann Goyen, LQMHP, LCAS, CSI, SA

  • Addiction (Substance Use Disorder) Counselor
  • Seven Springs, NC
National Provider Identifier
1124474291
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
4734 Liddell Shortcut Rd
Seven Springs, NC 28578-9469
Phone
(336) 402-1527
NPI assigned
May 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-28487 NC

Addresses

Primary practice location

4734 Liddell Shortcut Rd
Seven Springs, NC 28578-9469

Mailing address

1203 Berkley Hall Manor LN Apt 1G
Greensboro, NC 27409-9816
Phone (336) 402-1527

Other practice location 1

215A Memorial Dr
Jacksonville, NC 28546-6333
Phone (910) 378-4870

Other practice location 2

1700 E Ash St Ste 200
Goldsboro, NC 27530-4097
Phone (919) 241-7153

Other practice location 3

919 Phillips Ave Ste 107
High Point, NC 27262-7076
Phone (336) 899-8889 ext. 103

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

State licenses

LicenseStateTypeSpecialty
LCAS-28487NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Haven Recovery Addiction (Substance Use Disorder) CurrentSince Mar 12, 2024 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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1124474291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 BERKLEY HALL MANOR LN APT 1G",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099816",
            "telephone_number": "336-402-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4734 LIDDELL SHORTCUT RD",
            "city": "SEVEN SPRINGS",
            "state": "NC",
            "postal_code": "285789469",
            "telephone_number": "336-402-1527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215A Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466333",
            "country_code": "US",
            "telephone_number": "910-378-4870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 E Ash St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275304097",
            "country_code": "US",
            "telephone_number": "919-241-7153",
            "fax_number": "919-583-9358",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "919 Phillips Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272627076",
            "country_code": "US",
            "telephone_number": "336-899-8889 x103",
            "fax_number": "336-790-3999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOYEN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LQMHP, LCAS, CSI, SA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-28487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seven Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.