Active NPI
Mildred Ladean Phipps, LPC, LCAS
- Addiction (Substance Use Disorder) Counselor
- Concord, NC
National Provider Identifier
1194909754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 129
- Practice address
- 284 Executive Park Dr
Suite 100
Concord, NC 28025-1831 - Phone
- (704) 939-1100
- Fax
- (704) 939-1173
- NPI assigned
- Dec 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 129 | NC | Primary |
| Mental Health Counselor | 101YM0800X | 3258 |
Addresses
Primary practice location
284 Executive Park Dr
Suite 100
Concord, NC 28025-1831
Mailing address
284 Executive Park Dr
Suite 100
Concord, NC 28025-1831
Phone (704) 939-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102362 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 129 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1194909754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR",
"address_2": "SUITE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251831",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR",
"address_2": "SUITE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251831",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHIPPS",
"first_name": "MILDRED",
"middle_name": "LADEAN",
"credential": "LPC, LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-19",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "129",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": "3258",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6102362",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
- Kaci Schenk Phillips
- Lorree Michelle Phillips, LPC-A, LCAS
- Rebecca Kathleen Phillips
- Taylor Phillips, ATC
- Teresa L Phillips, MA,EDS,LPC
- Jennifer Isabel Piana, LCSW
- Latonja Pickett, MSW, LCSW
- Piedmont Area MH, DD and Sa Authority
- Piedmont Area MH, DD and Sa Authority
- Piedmont Area MH, DD and Sa Authority
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.