Glenda Lena Vinson-Nnaji, LCMHCS, LCAS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6103193 Issued in NC

Practice address

317 Matthews Mint Hill Rd Ste 207
Matthews, NC 28105-2895

Phone

(704) 619-3490

Fax

(704) 849-5251

NPI assigned

Mar 18, 2007

Last updated

Aug 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1275657132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 MATTHEWS MINT HILL RD STE 207",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052895",
            "telephone_number": "704-619-3490",
            "fax_number": "704-849-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 MATTHEWS MINT HILL RD STE 207",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052895",
            "telephone_number": "704-619-3490",
            "fax_number": "704-849-5251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9700 Research Dr",
            "address_2": "Ste 142",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282628552",
            "country_code": "US",
            "telephone_number": "704-358-9489",
            "fax_number": "704-358-9489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINSON-NNAJI",
        "first_name": "GLENDA",
        "middle_name": "LENA",
        "name_prefix": "Mrs.",
        "credential": "LCMHCS, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-2934",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S5220",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "6103193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103193",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Matthews, NC
• Providers in Matthews, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.