Individual provider Active NPI

Paul A Louis Jr., LCMHC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1407409691
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
14146 Issued in NC
Practice address
10620 Park Rd Ste 208
Charlotte, NC 28210-0106
Phone
(704) 360-3637
NPI assigned
Jul 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 14146 NC Primary

Addresses

Primary practice location

10620 Park Rd Ste 208
Charlotte, NC 28210-0106

Mailing address

10620 Park Rd Ste 208
Charlotte, NC 28210-0106
Phone (704) 360-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122004593 NC Practitioner - Mental Health Counselor 6608228937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

10620 Park Rd
Suite 208
Charlotte, NC 28210-0106
Phone (704) 360-3637

3625 N Elm St
Suite 130
Greensboro, NC 27455-2604
Phone (704) 360-3637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1407409691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 PARK RD STE 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100106",
            "telephone_number": "704-360-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 PARK RD STE 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100106",
            "telephone_number": "704-360-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.