Active NPI
Sanita A Moulton, M.A.C.C., LMFT
- Marriage & Family Therapist
- Charlotte, NC
National Provider Identifier
1386878601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1359
- Practice address
- 1913 J N Pease PL
Suite 104
Charlotte, NC 28262-4556 - Phone
- (704) 236-9675
- Fax
- (704) 548-9247
- NPI assigned
- May 14, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1359 | NC | Primary |
| Mental Health Counselor | 101YM0800X | 1359 | NC |
Addresses
Primary practice location
1913 J N Pease PL
Suite 104
Charlotte, NC 28262-4556
Mailing address
1913 J N Pease PL
Suite 104
Charlotte, NC 28262-4556
Phone (704) 236-9675
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1359 | Other | NC | NCMFT LICENSURE BORAD |
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 |
|---|---|---|---|
| 1359 | NC | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Embrace Chabaq Ministries | Marriage & Family Therapist | Current | 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.
-
- Marriage & Family Therapist
- Charlotte, NC
- NPI 1396316089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307664000000",
"number": "1386878601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1913 J N PEASE PL",
"address_2": "SUITE 104",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282624556",
"telephone_number": "704-236-9675",
"fax_number": "704-548-9247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1913 J N PEASE PL",
"address_2": "SUITE 104",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282624556",
"telephone_number": "704-236-9675",
"fax_number": "704-548-9247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTON",
"first_name": "SANITA",
"middle_name": "A",
"credential": "M.A.C.C., LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-14",
"last_updated": "2011-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1359",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "1359",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCMFT LICENSURE BORAD",
"identifier": "1359",
"state": "NC"
}
],
"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 Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.