Shabria Latae Mayne, MS, LPC, LCASA, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12424 Issued in NC

Practice address

5200 Park Rd Ste 218B
Charlotte, NC 28209-3650

Phone

(866) 700-1606

Fax

(866) 338-5921

NPI assigned

Aug 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, DC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, NC, Professional

  Medicare reassignment NPD
• Mayne Counseling Services

  • Mental Health Counselor
  • Arlington, VA
  • NPI 1184321937
  NPD Authorized official
• Aevum BH VA LLC

  • General Practice Physician
  • Richmond, VA
  • NPI 1225856008

  DC

  Medicare reassignment
• Sparc Network

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1396155834

  Professional

  NPD (past)

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1467908939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 218B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093650",
            "telephone_number": "866-700-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 218B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093650",
            "telephone_number": "866-700-1606",
            "fax_number": "866-338-5921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 Harris Ave",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283763112",
            "country_code": "US",
            "telephone_number": "910-848-1638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNE",
        "first_name": "SHABRIA",
        "middle_name": "LATAE",
        "credential": "MS, LPC, LCASA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "12424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "402 Harris Ave",
            "city": "Raeford",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283763112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Lucille Mayle
• Alexander D Maynard
• Brittany Maynard
• Debra Hill Maynard, MS, RDN
• John Ryan Maynard, P.A.
• Katherine Maynor, MSW, LCSW
• Michael Mayo
• Patricia Cox Mayo, M.S., CCC-SLP
• Nyimon Mayom
• Mays Counseling Services

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, 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 Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.