Nicole M Moman, LCMHC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12569 Issued in NC

Practice address

6 Park PL W
Brevard, NC 28712-3081

Phone

(828) 553-3875

Fax

(888) 717-5718

NPI assigned

Dec 2, 2019

Last updated

Apr 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Calm River Counseling

  • Community/Behavioral Health Agency
  • Brevard, NC
  • NPI 1144867789

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1417594045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 WALNUT HOLLOW RD",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287128584",
            "telephone_number": "285-533-8758",
            "fax_number": "888-717-5718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARK PL W",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287123081",
            "telephone_number": "828-553-3875",
            "fax_number": "888-717-5718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMAN",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "LCMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "12569",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "12569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Brevard",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "45 N Country Club Rd",
            "city": "Brevard",
            "state": "NC",
            "country_code": "US",
            "postal_code": "287128908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mission Medical Associates Inc (Mission Weight Management Center)
• Mission Medical Associates Inc (MMA Inpatient Neurology)
• Mission Medical Associates Inc (MMA Psychiatric Services)
• Mission Medical Associates, Inc (Mission Behavioral Health-Transylvania)
• Polly Mitchiner-Senecal
• Stephen Monk, PHARMD
• Sheila G. Mooney, LPC
• Craig Cowan Moore, MD IM
• Sheila G. Moore
• Mountain Area Health Education Center, Inc. (MAHEC Women's Care at Brevard)

• Professional Counselor in Brevard, NC
• Providers in Brevard, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.