Individual provider Active NPI

Katherine Mendat List, LPCS

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1306162334
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S7867 Issued in NC
Practice address
1020 Washington St
Raleigh, NC 27605-1258
Phone
(919) 551-2312
Fax
(919) 516-0057
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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 7867 NC
Mental Health Counselor 101YM0800X S7876 NC
Mental Health Counselor 101YM0800X S7867 NC Primary

Addresses

Primary practice location

1020 Washington St
Raleigh, NC 27605-1258

Mailing address

3913 Iron Horse Rd
Raleigh, NC 27616-5044
Phone (843) 367-4819

Other practice location 1

8394 Six Forks Rd Ste 104
Raleigh, NC 27615-3057
Phone (843) 367-4819

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
7867NCMDMental Health Counselor
S7867NCMDMental Health Counselor
S7876NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindly Group, PLLC Mental Health CurrentSince Oct 23, 2021 Accepting new patients

Locations

8394 Six Forks Rd
Ste 104
Raleigh, NC 27615
Phone (843) 367-4819

8406 Six Forks Rd
Ste 204
Raleigh, NC 27615
Phone (919) 617-9656

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1306162334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3913 IRON HORSE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276165044",
            "telephone_number": "843-367-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WASHINGTON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051258",
            "telephone_number": "919-551-2312",
            "fax_number": "919-516-0057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8394 Six Forks Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276153057",
            "country_code": "US",
            "telephone_number": "843-367-4819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIST",
        "first_name": "KATHERINE",
        "middle_name": "MENDAT",
        "credential": "LPCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "7867",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S7876",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S7867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.