Individual provider Active NPI

Stacy Lacole Salmon, MA

  • Counselor
  • Charlotte, NC
National Provider Identifier
1417164344
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3812 Dry Brook Rd
Apt I
Charlotte, NC 28269-0765
Phone
(423) 833-9476
Fax
(423) 833-9476
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10113 NC
Counselor 101Y00000X Primary

Addresses

Primary practice location

3812 Dry Brook Rd
Apt I
Charlotte, NC 28269-0765

Mailing address

2553 Willow Pond LN SE
Concord, NC 28025-0030
Phone (980) 888-3711

Other names 1

  • Mrs. Stacy Lacole Salmon Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10113NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1417164344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 WILLOW POND LN SE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280250030",
            "telephone_number": "980-888-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 DRY BROOK RD",
            "address_2": "APT I",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282690765",
            "telephone_number": "423-833-9476",
            "fax_number": "423-833-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMON",
        "first_name": "STACY",
        "middle_name": "LACOLE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10113",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "SALMON",
            "middle_name": "LACOLE",
            "prefix": "MRS.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Oct 24, 2022; 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.