Individual provider Active NPI

Courtney Danielle McMillian, LCMHC, CRC

  • Mental Health Counselor
  • Lexington, NC
National Provider Identifier
1144608944
Registry record updated Nov 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11503 Issued in NC
Practice address
193 Creekstone CT
Lexington, NC 27295
Phone
(336) 473-7739
NPI assigned
May 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CRC# 00119166 NC
Counselor 101Y00000X A11503 NC
Counselor 101Y00000X 11503 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-21598 NC
Mental Health Counselor 101YM0800X 11503 NC Primary

Addresses

Primary practice location

193 Creekstone CT
Lexington, NC 27295

Mailing address

193 Creekstone CT
Lexington, NC 27295-8070

Other practice location 1

175 Kimel Park Dr Ste 100
Winston Salem, NC 27103-6951
Phone (336) 718-3550

Other practice location 2

582 Wrenn Dr
Lexington, NC 27292-7598
Phone (336) 473-7739

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
A11503NCMDCounselor
CRC# 00119166NCMDCounselor
LCAS-21598NCMDAddiction (Substance Use Disorder) Counselor
11503NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700956800000",
    "number": "1144608944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 CREEKSTONE CT",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272958070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 CREEKSTONE CT",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "27295",
            "telephone_number": "336-473-7739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Kimel Park Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036951",
            "country_code": "US",
            "telephone_number": "336-718-3550",
            "fax_number": "336-277-1825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "582 Wrenn Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "NC",
            "postal_code": "272927598",
            "country_code": "US",
            "telephone_number": "336-473-7739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLIAN",
        "first_name": "COURTNEY",
        "middle_name": "DANIELLE",
        "credential": "LCMHC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2023-11-26",
        "certification_date": "2023-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "CRC# 00119166",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A11503",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "11503",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21598",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2023; 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.