Individual provider Active NPI

Jelissa Christina Deese, MS, LCMHCA, NCC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1144175811
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A22603 Issued in NC
Practice address
4222 Poplar Grove Dr
Charlotte, NC 28269-0433
Phone
(704) 608-8234
NPI assigned
Feb 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A22603 NC Primary

Addresses

Primary practice location

4222 Poplar Grove Dr
Charlotte, NC 28269-0433

Mailing address

4222 Poplar Grove Dr
Charlotte, NC 28269-0433
Phone (704) 608-8234

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
A22603NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1144175811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 POPLAR GROVE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282690433",
            "telephone_number": "704-608-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 POPLAR GROVE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282690433",
            "telephone_number": "704-608-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEESE",
        "first_name": "JELISSA",
        "middle_name": "CHRISTINA",
        "credential": "MS, LCMHCA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A22603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.