Individual provider Active NPI

Tamikia Scott Greene, ED. D, LPCS, LCAS

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1487803904
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
S7087 Issued in NC
Practice address
10130 Mallard Creek Rd Ste 323
Charlotte, NC 28262-6000
Phone
(704) 564-8833
NPI assigned
Sep 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X S7087 NC Primary

Addresses

Primary practice location

10130 Mallard Creek Rd Ste 323
Charlotte, NC 28262-6000

Mailing address

10902 Charmont PL
Huntersville, NC 28078-1329
Phone (704) 564-8833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250106003669 NC Practitioner - Mental Health Counselor 7618160540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S7087NCMDProfessional Counselor
7087NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tgreene Consulting & Therapeutic Services CurrentSince Sep 25, 2024 Accepting new patients

Locations

10130 Mallard Creek Rd
Ste 323
Charlotte, NC 28262
Phone (704) 564-8833

8611 Concord Mills Blvd
Concord, NC 28027
Phone (214) 766-9013

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1487803904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10902 CHARMONT PL",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280781329",
            "telephone_number": "704-564-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 MALLARD CREEK RD STE 323",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282626000",
            "telephone_number": "704-564-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "TAMIKIA",
        "middle_name": "SCOTT",
        "name_prefix": "Mrs.",
        "credential": "ED. D, LPCS, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "S7087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.