The Intentional Mind Counseling Services, P.L.L.C

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE INTENTIONAL MIND COUNSELING SERVICES, P.L.L.C

Practice address

115 Unionville Indian Trail Rd W # a-5
Indian Trail, NC 28079-5583

Phone

(910) 750-2682

NPI assigned

Apr 18, 2025

Organization subpart

No

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

Authorized official

Name

David Jerome Lewis II, LPC, LCHMCNPI 1710699004

Title

Owner

Phone

(910) 750-2682

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David J. Lewis

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1710699004
  NPD Authorized official

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

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1417743964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 OCONNELL ST",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280796792",
            "telephone_number": "704-312-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 UNIONVILLE INDIAN TRAIL RD W # A-5",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795583",
            "telephone_number": "910-750-2682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INTENTIONAL MIND COUNSELING SERVICES, P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-750-2682",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "LPC, LCHMC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.