William Ashley Mizelle Jr., LCAS,LCMHC,CCS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1061 Issued in NC

Practice address

2602 Courtier Dr
Greenville, NC 27834-7818

Phone

(252) 752-0483

Fax

(252) 757-3172

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Port Health Services

  • Counselor
  • Greenville, NC
  • NPI 1497075618
  Medicare reassignment NPD
• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1306167713

  Mental Health

  NPD
• Port Health Services

  • Community/Behavioral Health Agency
  • Whiteville, NC
  • NPI 1174005789
  NPD
• Port Health Services

  • Counselor
  • Kinston, NC
  • NPI 1720145535
  NPD

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1154497220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 TULL RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278588366",
            "telephone_number": "252-814-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 COURTIER DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347818",
            "telephone_number": "252-752-0483",
            "fax_number": "252-757-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZELLE",
        "first_name": "WILLIAM",
        "middle_name": "ASHLEY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCAS,LCMHC,CCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "6860",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "10014",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "6860",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111889",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "191488",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "143KY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanesha Larshine Mitchell, LCSWA
• Timothy Wilbur Mitchell Jr., LCSWA
• Coley Benton Mizell
• Juanita Mizell, PT, DPT
• Nathalie Diona Mizelle-Johnson, PH.D.
• Linda Raye Mizzelle, LCSW
• Mobile Transportation Services, LLC
• Katherine Mobley
• Aakash Modi, M.D.
• Ritu Modi, M.D

• Addiction (Substance Use Disorder) Counselor in Greenville, NC
• Providers in Greenville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.