Active NPI
Nicole Shelton, LCAS A
- Addiction (Substance Use Disorder) Counselor
- Concord, NC
National Provider Identifier
1407211790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 25163
- Practice address
- 245 Executive Park Dr.
Concord, NC 28025-1833 - Phone
- (704) 939-1100
- NPI assigned
- Dec 31, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 25163 | NC | Primary |
Addresses
Primary practice location
245 Executive Park Dr.
Concord, NC 28025-1833
Mailing address
318 Turnersburg Hwy
Statesville, NC 28625-2798
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 |
|---|---|---|---|
| 25163 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495756800000",
"number": "1407211790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 TURNERSBURG HWY",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286252798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 EXECUTIVE PARK DR.",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "NICOLE",
"credential": "LCAS A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-31",
"last_updated": "2017-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "25163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.