Micaiah Blanchard, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17293 Issued in NC

Practice address

425 McArthur Dr
Elizabeth City, NC 27909-4566

Phone

(443) 752-6329

NPI assigned

Sep 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 29, 2024 through Apr 29, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Harbor Counseling PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elizabeth City, NC
  • NPI 1891342606
  NPD (past)

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1366059743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 RANCH DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099698",
            "telephone_number": "443-752-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MCARTHUR DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094566",
            "telephone_number": "443-752-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "MICAIAH",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "17293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elias Bertoluzzi, D.P.T.
• BHG Lxxxi, LLC (BHG Medical Services - North Carolina)
• Bigmerica Inc (Help Systems of Health Care)
• Bigmerica, Inc (Foundation Health and Human Services)
• Shayla Bishop, RBT
• Scott C Blanchard, DDS
• Jack Blitz
• Brittany Mann Blizzard
• Sherman B Blystone Jr., PT
• Kelly Bond

• Mental Health Counselor in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.