Individual provider Active NPI

Cindy M. Nelson, LCPC

  • Mental Health Counselor
  • Goldsboro, NC
National Provider Identifier
1295926343
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9904 Issued in NC
Practice address
208 Malloy St
Unit E
Goldsboro, NC 27534-4478
Phone
(919) 778-5594
Fax
(919) 778-5633
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCPC-7771 ID
Mental Health Counselor 101YM0800X 0107881 NM
Mental Health Counselor 101YM0800X 9904 NC Primary

Addresses

Primary practice location

208 Malloy St
Unit E
Goldsboro, NC 27534-4478

Mailing address

1020 W Franklin St Ste 110
Boise, ID 83702-5400
Phone (208) 917-3346

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
LCPC-7771IDMDMental Health Counselor
0107881NMMDMental Health Counselor
9904NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsboro Counseling Center, P.a. Professional PastSince Jun 1, 2009 Accepting new patients

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1295926343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W FRANKLIN ST STE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025400",
            "telephone_number": "208-917-3346",
            "fax_number": "208-906-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MALLOY ST",
            "address_2": "UNIT E",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344478",
            "telephone_number": "919-778-5594",
            "fax_number": "919-778-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CINDY",
        "middle_name": "M.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-7771",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0107881",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "9904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.