Individual provider Active NPI

Michael R Burson, LCMHCA, NCC, MA

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1457014052
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A16530 Issued in NC
Practice address
9609 Whitewood TRL
Charlotte, NC 28269-0432
Phone
(828) 400-6014
NPI assigned
Oct 20, 2021
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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 A16530 NC Primary

Addresses

Primary practice location

9609 Whitewood TRL
Charlotte, NC 28269-0432

Mailing address

9609 Whitewood TRL
Charlotte, NC 28269-0432
Phone (828) 400-6014

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
A16530NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1457014052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9609 WHITEWOOD TRL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282690432",
            "telephone_number": "828-400-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9609 WHITEWOOD TRL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282690432",
            "telephone_number": "828-400-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSON",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "LCMHCA, NCC, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 20, 2021; 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.