Individual provider Active NPI

Liza Devine

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1164360343
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A22641 Issued in NC
Practice address
2237 Park Rd
Charlotte, NC 28203-5922
Phone
(980) 389-0619
NPI assigned
Mar 23, 2026
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 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 A22641 NC Primary

Addresses

Primary practice location

2237 Park Rd
Charlotte, NC 28203-5922

Mailing address

508 East Blvd
Charlotte, NC 28203-5110
Phone (980) 389-0619

Other practice location 1

508 East Blvd
Charlotte, NC 28203-5110
Phone (980) 389-0619

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
A22641NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1164360343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 EAST BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035110",
            "telephone_number": "980-389-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035922",
            "telephone_number": "980-389-0619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 East Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035110",
            "country_code": "US",
            "telephone_number": "980-389-0619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "LIZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A22641",
            "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 23, 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.