Joanna Lisa Von Staden, MA, LCMHCA, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A16656 Issued in NC

Practice address

9541 Julian Clark Ave Ste 100
Huntersville, NC 28078-3484

Phone

(980) 358-1366

NPI assigned

Sep 2, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Healingworks Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Huntersville, NC
  • NPI 1518634500
  NPD (past)

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1497423479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9541 JULIAN CLARK AVE STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783484",
            "telephone_number": "980-358-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9541 JULIAN CLARK AVE STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783484",
            "telephone_number": "980-358-1366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12524 Vantage Point Ln",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787110",
            "country_code": "US",
            "telephone_number": "980-298-4855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VON STADEN",
        "first_name": "JOANNA",
        "middle_name": "LISA",
        "credential": "MA, LCMHCA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951767480P",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "@healingworkscounseling.com",
            "affiliation": "Y",
            "affiliationName": "HealingWorks Counseling PLLC",
            "address_1": "9451 Julian Clark Ave",
            "address_2": "Suite 110",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "@gmail.com",
            "affiliation": "N",
            "address_1": "12524 Vantage Point Ln",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2022; 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.