Individual provider Active NPI

Amy Leigh Mock, MA, LPC

  • Mental Health Counselor
  • Charlotte, NC
National Provider Identifier
1497807515
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5327 Issued in NC
Practice address
2301 W Morehead St
Suite B
Charlotte, NC 28208-5271
Phone
(704) 497-0824
NPI assigned
Jan 17, 2007
Last updated
Aug 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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 5327 NC Primary

Addresses

Primary practice location

2301 W Morehead St
Suite B
Charlotte, NC 28208-5271

Mailing address

2301 W Morehead St
Suite B
Charlotte, NC 28208-5271
Phone (704) 497-0824

Other identifiers 1

IdentifierTypeStateIssuer
6103263MedicaidNC

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1497807515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 W MOREHEAD ST",
            "address_2": "SUITE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085271",
            "telephone_number": "704-497-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W MOREHEAD ST",
            "address_2": "SUITE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282085271",
            "telephone_number": "704-497-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "AMY",
        "middle_name": "LEIGH",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103263",
            "state": "NC"
        }
    ],
    "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 Aug 8, 2012; 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.