Individual provider Active NPI

Rachelle P McKoy

  • Mental Health Counselor
  • Shelby, NC
National Provider Identifier
1225125123
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5324 Issued in NC
Practice address
1760 E Dixon Blvd
Shelby, NC 28152-6948
Phone
(704) 480-9344
Fax
(704) 482-8494
NPI assigned
Oct 10, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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 5324 NC Primary

Addresses

Primary practice location

1760 E Dixon Blvd
Shelby, NC 28152-6948

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240301001963 NC Practitioner - Mental Health Counselor 7012352925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5324NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc. CurrentSince Feb 26, 2024 Accepting new patients
Gaston Family Health Services, Inc CurrentSince Feb 26, 2024 Accepting new patients
Gaston Family Health Services, Inc. CurrentSince Feb 18, 2024 Accepting new patients

Locations

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

1760 E Dixon Blvd
Shelby, NC 28152
Phone (704) 480-9344

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1225125123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1907",
            "fax_number": "704-865-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526948",
            "telephone_number": "704-480-9344",
            "fax_number": "704-482-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOY",
        "first_name": "RACHELLE",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.