Individual provider Active NPI

Esther Waycam Mfonyam, LMFTA

  • Marriage & Family Therapist
  • Charlotte, NC
National Provider Identifier
1366788432
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
8052A Issued in NC
Practice address
3705 Latrobe Dr
Suite 340
Charlotte, NC 28211-4824
Phone
(704) 364-3989
NPI assigned
Dec 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 8052A NC Primary

Addresses

Primary practice location

3705 Latrobe Dr
Suite 340
Charlotte, NC 28211-4824

Mailing address

7818A Renaissance CT
Charlotte, NC 28226-3932
Phone (803) 530-0668

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
8052ANCMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1366788432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7818A RENAISSANCE CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263932",
            "telephone_number": "803-530-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 LATROBE DR",
            "address_2": "SUITE 340",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114824",
            "telephone_number": "704-364-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MFONYAM",
        "first_name": "ESTHER",
        "middle_name": "WAYCAM",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "8052A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.