Active NPI
Michelle Lee Roach, LPC
- Mental Health Counselor
- Durham, NC
National Provider Identifier
1477852440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8541
- Practice address
- 1209A Sedgefield St
Durham, NC 27705-3545 - Phone
- (919) 602-6439
- NPI assigned
- Mar 16, 2011
- Last updated
- Aug 30, 2012
- 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 | 8541 | NC | Primary |
Addresses
Primary practice location
1209A Sedgefield St
Durham, NC 27705-3545
Mailing address
4600 Emperor Blvd
Durham, NC 27703-8577
Phone (919) 651-8400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 10, 2025 through Oct 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8541 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346284800000",
"number": "1477852440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 EMPEROR BLVD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277038577",
"telephone_number": "919-651-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1209A SEDGEFIELD ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277053545",
"telephone_number": "919-602-6439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "MICHELLE",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-16",
"last_updated": "2012-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "8541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.