Matthew Dail McMillan, MS,LCAS, LCMHC, CCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2489 Issued in NC

Practice address

822 N Elm St Ste 109
Greensboro, NC 27401-1538

Phone

(336) 329-8506

Fax

(336) 510-4434

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Impact4Today, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greensboro, NC
  • NPI 1205523917
  NPD Authorized official

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1306897947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 BATTLEGROUND AVE",
            "address_2": "#321",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274081925",
            "telephone_number": "336-329-8506",
            "fax_number": "336-510-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 N ELM ST STE 109",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011538",
            "telephone_number": "336-329-8506",
            "fax_number": "336-510-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "MATTHEW",
        "middle_name": "DAIL",
        "name_prefix": "Mr.",
        "credential": "MS,LCAS, LCMHC, CCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "535",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Matthew@Impact4today.com",
            "affiliation": "N",
            "endpointDescription": "Greensboro Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Greensboro",
            "address_1": "822 N Elm St Ste 109",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Howard McMasters, J.HOWARD MCMASTERS
• Kim Lavette McMasters, D.C.
• Bayley McMichael, PA
• Jillian McMichael
• Kylie Nicole McMillan
• Michael Lindsay McMillen, CRNA
• McMillian DDS and Morrone DMD, PA
• Alison J. McMillian, D.D.S.,M.S.,P.A.
• Shawnta McMillian, LPC
• Ciara Kathleen McMillin, CCC-SLP

• Professional Counselor in Greensboro, NC
• Providers in Greensboro, 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 Mar 20, 2020; 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.