Individual provider Active NPI

Megan Jane Panzanella

  • Mental Health Counselor
  • Matthews, NC
National Provider Identifier
1356955769
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A16646 Issued in NC
Practice address
250 N Trade St Ste 300
Matthews, NC 28105-9433
Phone
(980) 422-6977
NPI assigned
Sep 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X A16646
Mental Health Counselor 101YM0800X A16646 NC Primary

Addresses

Primary practice location

250 N Trade St Ste 300
Matthews, NC 28105-9433

Mailing address

250 N Trade St Ste 300
Matthews, NC 28105-9433
Phone (980) 422-6977

Other practice location 1

1136 Sam Newell Rd
Matthews, NC 28105-5063
Phone (980) 422-6977

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
A16646NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Renfrew Centers, Inc. PastSince Sep 1, 2020 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": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1356955769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N TRADE ST STE 300",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281059433",
            "telephone_number": "980-422-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N TRADE ST STE 300",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281059433",
            "telephone_number": "980-422-6977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1136 Sam Newell Rd",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281055063",
            "country_code": "US",
            "telephone_number": "980-422-6977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANZANELLA",
        "first_name": "MEGAN",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "A16646",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.