Clinicians of Mecklenburg

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CLINICIANS OF MECKLENBURG

Practice address

11 Union St S # Ll207
Concord, NC 28025-5059

Phone

(919) 672-5005

NPI assigned

Oct 15, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Dashun Banks, LPCNPI 1972821916

Title

Ceo

Phone

(919) 672-5005

Specialties & licenses 8

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dashun Tyrell Banks, NCLPCBE

  • Counselor
  • Concord, NC
  • NPI 1972821916
  NPD Authorized official
• Krystina Bennett

  • Mental Health Counselor
  • Concord, NC
  • NPI 1417674524
  NPD
• Javious Ellis, MSW

  • Clinical Social Worker
  • Shelby, NC
  • NPI 1821611518

  Professional

  NPD (past)
• Francisca Ngozi Odoemena, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1942814298
  NPD (past)

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1174099436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 UNION ST S # LL207",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255059",
            "telephone_number": "919-672-5005",
            "fax_number": "800-806-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UNION ST S # LL207",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255059",
            "telephone_number": "919-672-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICIANS OF MECKLENBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "DASHUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-672-5005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33625",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Freudenberg Clements, PHARMD
• Natalie Clevinger
• Clifford C Compton III DDS PA
• Cody Clifton, PHARMD
• Gabrielle C Clinch, DPT
• Glennisha Clinkscale
• Brittany Clodfelter
• Amber James Clontz, FNP
• Ashley Clontz, MSW
• Jasmine Arielle Clyde, DDS

• Mental Health Counselor in Concord, NC
• Providers in Concord, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.