Active NPI
Joonah Lucy Nesbitt
- Mental Health Counselor
- Concord, NC
National Provider Identifier
1164093902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 212 Le Phillip CT NE Ste 103
Concord, NC 28025-1901 - Phone
- (980) 255-8745
- NPI assigned
- Jul 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
212 Le Phillip CT NE Ste 103
Concord, NC 28025-1901
Mailing address
7205 Winslow Dr
Waxhaw, NC 28173-8012
Phone (704) 261-6346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 2, 2024 through Nov 2, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15954 | NC | MD | Critical Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625184000000",
"number": "1164093902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7205 WINSLOW DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281738012",
"telephone_number": "704-261-6346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 LE PHILLIP CT NE STE 103",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251901",
"telephone_number": "980-255-8745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NESBITT",
"first_name": "JOONAH",
"middle_name": "LUCY",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-02",
"last_updated": "2021-07-02",
"certification_date": "2021-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.