Active NPI
Robin Wall, LPC
- Mental Health Counselor
- Greenville, NC
National Provider Identifier
1477789519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 102 Fox Haven Dr
#A
Greenville, NC 27858-9720 - Phone
- (252) 353-7025
- Fax
- (252) 353-7028
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
102 Fox Haven Dr
#A
Greenville, NC 27858-9720
Mailing address
102 Fox Haven Dr
#A
Greenville, NC 27858-9720
Phone (252) 353-7025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 17, 2024 through Jan 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7377 | NC | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243987200000",
"number": "1477789519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 FOX HAVEN DR",
"address_2": "#A",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278589720",
"telephone_number": "252-353-7025",
"fax_number": "252-353-7028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 FOX HAVEN DR",
"address_2": "#A",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278589720",
"telephone_number": "252-353-7025",
"fax_number": "252-353-7028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "ROBIN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-03",
"last_updated": "2009-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.