Individual provider Active NPI

Raul Antonio Zambrano III, LCMHC-A

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1467934794
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A14227 Issued in NC
Practice address
7940 Williams Pond LN Ste 250
Charlotte, NC 28277-8412
Phone
(704) 341-7401
NPI assigned
Sep 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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 A14227 NC Primary

Addresses

Primary practice location

7940 Williams Pond LN Ste 250
Charlotte, NC 28277-8412

Mailing address

25075 Woodhaven Dr
Tega Cay, SC 29708-8323
Phone (386) 299-7950

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

State licenses

LicenseStateTypeSpecialty
A14227NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: raulzambrano@tdh.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1467934794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25075 WOODHAVEN DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297088323",
            "telephone_number": "386-299-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7940 WILLIAMS POND LN STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778412",
            "telephone_number": "704-341-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMBRANO",
        "first_name": "RAUL",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCMHC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A14227",
            "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 Jul 20, 2020; 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.