Active NPI
Mary Jean Elder, LCMHC
- Counselor
- Gastonia, NC
National Provider Identifier
1306244223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 11232
- Practice address
- 4521 Beaty Rd
Gastonia, NC 28056-8337 - Phone
- (704) 237-0236
- Fax
- (704) 675-7317
- NPI assigned
- Dec 9, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11232 | NC | |
| Professional Counselor | 101YP2500X | 11232 | NC | |
| Counselor | 101Y00000X | 11232 | NC | Primary |
Addresses
Primary practice location
4521 Beaty Rd
Gastonia, NC 28056-8337
Mailing address
4521 Beaty Rd
Gastonia, NC 28056-8337
Phone (704) 237-0236
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11232 | NC | MD | Gerontology Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deep River Counseling, PLLC | Professional | Current | Accepting new patients |
Locations
4521 Beaty Rd
Gastonia, NC 28056
Phone (704) 237-0236
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": "1418083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762992000000",
"number": "1306244223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4521 BEATY RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280568337",
"telephone_number": "704-237-0236",
"fax_number": "704-675-7317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4521 BEATY RD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280568337",
"telephone_number": "704-237-0236",
"fax_number": "704-675-7317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "MARY",
"middle_name": "JEAN",
"credential": "LCMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-09",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "11232",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "11232",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "11232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.