Individual provider Active NPI

Marcus L Robinson, LCMHC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1205175809
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8478 Issued in NC
Practice address
10643 Kettering Dr. Suite 109
Charlotte, NC 28226
Phone
(704) 762-1361
NPI assigned
Feb 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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 8478 NC Primary

Addresses

Primary practice location

10643 Kettering Dr. Suite 109
Charlotte, NC 28226

Mailing address

10617 Kettering Dr Ste 109
Charlotte, NC 28226-4900
Phone (704) 762-1361

Other practice location 1

10617 Kettering Dr Ste 109
Charlotte, NC 28226-4900
Phone (704) 762-1361

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
8478NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridges Therapeutic Services PLLC Mental Health CurrentSince Feb 16, 2020 Accepting new patients

Locations

5970 Fairview Rd
Ste 126
Charlotte, NC 28210
Phone (704) 412-8830

10617 Kettering Dr
Ste 109
Charlotte, NC 28226
Phone (980) 500-9180

10643 Kettering Dr
Ste 109
Charlotte, NC 28226
Phone (704) 762-1361

111 Commerce Centre Dr
Ste 305
Huntersville, NC 28078
Phone (704) 451-9668

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1205175809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10617 KETTERING DR STE 109",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282264900",
            "telephone_number": "704-762-1361",
            "fax_number": "980-505-8947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10643 KETTERING DR. SUITE 109",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "704-762-1361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10617 Kettering Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282264900",
            "country_code": "US",
            "telephone_number": "704-762-1361",
            "fax_number": "980-505-8947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "MARCUS",
        "middle_name": "L",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-04",
        "last_updated": "2022-05-13",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8478",
            "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 May 13, 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.