Individual provider Active NPI

Shelley Wiegmann Mobley, LPC, LMFT

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1174666069
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC 414 Issued in NC
Practice address
1001 Queens Rd
Charlotte, NC 28207-1847
Phone
(980) 613-3400
Fax
(704) 569-9633
NPI assigned
Feb 14, 2007
Last updated
Jun 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC 414 NC Primary
Marriage & Family Therapist 106H00000X LMFT 421 NC

Addresses

Primary practice location

1001 Queens Rd
Charlotte, NC 28207-1847

Mailing address

1001 Queens Rd
Charlotte, NC 28207-1847
Phone (980) 613-3400

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
LPC 414NCMDMental Health Counselor
LMFT 421NCMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1174666069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 QUEENS RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071847",
            "telephone_number": "980-613-3400",
            "fax_number": "704-569-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 QUEENS RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071847",
            "telephone_number": "980-613-3400",
            "fax_number": "704-569-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "SHELLEY",
        "middle_name": "WIEGMANN",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "LPC 414",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "LMFT 421",
            "primary": false
        }
    ],
    "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 Jun 22, 2012; 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.