Individual provider Active NPI

Denise Siomah West, LCMHC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1285098780
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A15683 Issued in NC
Practice address
3545 Whitehall Park Dr Ste 300
Charlotte, NC 28273-4179
Phone
(980) 302-8850
Fax
(704) 316-8118
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APC006998 GA
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X A15683 NC Primary

Addresses

Primary practice location

3545 Whitehall Park Dr Ste 300
Charlotte, NC 28273-4179

Mailing address

769 N Wendover Rd
Charlotte, NC 28211-1118
Phone (704) 376-7180

Other practice location 1

270 Carpenter Dr
Suite 400
Sandy Springs, GA 30328-4931
Phone (678) 460-0345

Other practice location 2

250 Bray Street
Athens, GA 30601-2244
Phone (706) 612-6995

Other practice location 3

769 N Wendover Rd
Charlotte, NC 28211-1118
Phone (704) 376-7180

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
I20231220002048 NC Practitioner - Mental Health Counselor 4385094135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-5416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A15683NCMDMental Health Counselor
APC006998GAMDProfessional Counselor
15683NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Jan 1, 2024 Accepting new patients
NMG Health Services LLC CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group, LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jan 1, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Family Ties Inc. Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

1900 Randolph Rd
Ste 800
Charlotte, NC 28207
Phone (704) 941-4171

3545 Whitehall Park Dr
Ste 300
Charlotte, NC 28273
Phone (704) 316-6187

13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 7

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1285098780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 N WENDOVER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111118",
            "telephone_number": "704-376-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 WHITEHALL PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734179",
            "telephone_number": "980-302-8850",
            "fax_number": "704-316-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Carpenter Dr",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303284931",
            "country_code": "US",
            "telephone_number": "678-460-0345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Bray Street",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306012244",
            "country_code": "US",
            "telephone_number": "706-612-6995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "769 N Wendover Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111118",
            "country_code": "US",
            "telephone_number": "704-376-7180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "DENISE",
        "middle_name": "SIOMAH",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC006998",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.